Close tie between diabetes and sleep apnea
■ Physicians are urged to check for co-existing conditions to catch multiple ills, including hypertension.
By Susan J. Landers — Posted June 23, 2008
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Washington -- Now that several studies have detected a strong link between type 2 diabetes and obstructive sleep apnea, physicians should consider checking for both conditions in patients who seem to have only one, according to a new statement from the International Diabetes Federation, an umbrella organization of more than 200 groups in 160 countries, headquartered in Brussels, Belgium.
"While type 2 diabetes is recognized as a serious global epidemic, the severe health consequences of untreated sleep apnea -- especially in people with diabetes -- are not," said Paul Zimmet, MD, PhD, co-chair of the federation's Task Force on Epidemiology and Prevention.
Apnea is linked to cardiovascular disease as well as daytime sleepiness. Plus, studies have shown that treating sleep apnea can improve blood glucose levels.
Meanwhile, the U.S. Preventive Services Task Force released a recommendation to screen for diabetes if a patient's treated or untreated blood pressure routinely equals or exceeds 135/80 mm Hg.
A universal goal is to catch and treat diabetes as early as possible. Since many people have type 2 diabetes for years before symptoms begin, the earlier it is detected, the better, noted the task force in a statement in the June 3 Annals of Internal Medicine. If left untreated, the high blood glucose levels that characterize the disease can lead to blindness, kidney failure, nerve damage and heart disease.
The IDF's statement, which was to be presented June 7 at the American Diabetes Assn.'s annual scientific sessions in San Francisco, places the medical community on alert. "It is imperative that we better understand the relationship between diabetes and sleep apnea through research and establish appropriate standards of care for managing diabetes and co-morbidities such as sleep apnea," said Dr. Zimmet, who is also the foundation director for the International Diabetes Institute in Melbourne, Australia.
Recent studies have shown that as many as 40% of people with sleep apnea have type 2 diabetes and that more than half of those with type 2 diabetes have some form of sleep disorder, according to IDF.
People with obstructive sleep apnea should be screened routinely for metabolic disease and type 2 diabetes. People with diabetes should be checked for sleep apnea, particularly when presenting with classic symptoms such as witnessed apneas, heavy snoring or daytime sleepiness, and poor workplace performance, said the IDF statement.
Treatment for sleep apnea includes weight reduction in overweight people, reduction of alcohol intake and the use of continuous positive airway pressure.