There seems to be quite a lot of evidence supporting OSA as a risk factor for developing diabetes. Is Diabetes likewise a risk factor for developing OSA or is the increased prevalence in diabetic persons driven by obesity?
It is evident to me that the OSA precedes the onset of type 2 diabetes, both in my personal experience and in medical journal literature. Papers have been published showing that the chronic intermittent hypoxia of OSA leads to deterioration of pancreatic beta cells and also to insulin resistance. So OSA is a risk factor for diabetes, Diabetes is known to be more prevalent in the OSA population than in the general population. Thus if an individual is found to have diabetes, he or she should be tested for OSA, and treated for OSA if warranted. In that sense diabetes is a risk factor for OSA.
Hello Christoffer, this is a great question. In my clinical experience I have seen this correlation heavily between patients with OSA and type II diabetes. Whenever I have a patient whom states that they have type II diabetes in their medical history, I immediately do an airway screening. Unfortunately, 9/10 of those patients in my practice do tend to have some sort of sleep disordered breathing. But interestingly enough, after having my patients perform various oropharyngeal exercises their diabetes improves along with their airway. There are various studies which demonstrate that the use of oropharyngeal exercises serve as a wonderful Adjunct for treatment of OSA. I've attached one of those articles for your interest.
FYI-read the article “Sleep apnea tied to diabetes in large study” or see the study’s abstract in the American Journal of Respiratory and Critical Care Medicine. And to learn more about the connection between obstructive sleep apnea and Type 2, see “Sleep Apnea and Type 2 Diabetes: A Vicious Circle,” by Ralph Pascualy, MD, Director of the Swedish Sleep Medicine Institute.
I agree with Dr. Zizi- OSA-->Diabetes Type II---> Obesity can be a vicious cycle . Obesity is highly correlated with OSA, and someone who has OSA the Leptin and insulin uptake is affected. This will make it harder for a person to loose weight, and may push that person over the threshold to Diabetes Type II. Also for both men and women with OSA that are not necessarily obese, they will have elevated levels of fatty acids creating insulin sensitivities.Sleep deprivation also has to be taken into consideration , because in this occurs which also affects insulin sensitivity.
There is also physiologic dysregulation that occurs with both Diabetes Type II and OSA creating an inflammatory effect.
It will be more likely that OSA is caused by obesity than Diabetes Type II but may be a contributing factor to OSA through its metabolic inflammatory effects.