People who have type 2 (adult onset) diabetes and also experience sleep apnea 1 may be able to significantly lower their glucose levels if they treat their breathing disorder, researchers at the University of Illinois at Chicago say.
By reducing glucose levels, diabetics can cut their attendant risks for stroke, heart attack and kidney disease by approximately 6% to 12%. "This is of great clinical significance," says study author Dr. James Herdegen, medical director of the University's Center for Sleep and Ventilatory Disorders.
In the study, 25 type 2 diabetics who had been diagnosed with sleep apnea underwent standard treatment for the condition, called continuous positive airway pressure (CPAP). People using CPAP go to bed wearing a mask over their nose. The mask is attached to a machine that blows air through the bronchial tubes and into the lungs, preventing the back of the throat from closing. Using the mask for a minimum of four hours each night is needed for effective treatment, says Herdegen.
Most of the patients were male, averaging 50 years old, and had a body mass index (BMI) of 42, which is considered severely obese. Obesity is a known risk factor for diabetes as well as sleep apnea, and diabetics are nine times more likely to have sleep apnea than people who do not have the disease, Herdegen says.
Using the CPAP machine, the participants overall hemoglobin A1c levels were reduced by 0.5%, which is very similar to the reduction achieved by medication, Herdegen notes.
In addition, their average glucose levels one hour after eating—a key measurement when monitoring diabetes—dropped from 190 mg/dl to 135 mg/dl. Glucose levels that are between 140 and 160 mg/dl are considered manageable for diabetic patients. In people who do not have diabetes, levels between 70 and 120 mg/dl are considered healthy.
The strong results from this study indicate the need for a larger study to measure these effects, Herdegen says, but also suggest that screening for sleep apnea should be a regular part of treatment for type 2 diabetics.
"This study illustrates the fact that type 2 diabetics with a risk for sleep apnea should be screened, because we have a very effective treatment that will help them feel better, and improve their diabetes management," he says.
"This is a very good paper, and takes the known research about diabetes and sleep apnea one step further," says Dr. Meir Kryger, the director of the Sleep Disorders Center at
St. Boniface Hospital in Winnipeg, Manitoba, Canada, and author of A Woman's Guide to Sleep Disorders.
It has been established that sleep apnea impairs the body's ability to properly deal with glucose, but this work shows that treating sleep apnea improves the patient's glucose metabolism, he adds.
Herdegen notes that because the standard treatment for sleep apnea is complicated, compliance is uneven-approximately 50% to 60%. But, he says, the quality of the machines is improving and the masks are becoming more comfortable.
And, he adds, for diabetics who have sleep apnea, "the treatment brings not only short-term results but long-term benefits."
Safe Travel for Diabetics
Having diabetes should not prevent you from traveling. You just need to do some careful planning before you take any trips, says Cecilia Sauter, program coordinator of the University of Michigan Diabetes Education Program.
See your doctor six to eight weeks before you leave. That time period will allow you to make any necessary lifestyle changes to ensure your diabetes is under control before you depart.
Your doctor should…
- Tell you what medications for diarrhea and vomiting—should your stomach have trouble with food or beverages on your trip-you can use without upsetting your diabetes care plan.
- Give you advice about what to do if you get seriously ill on your trip.
- Provide a letter that says you have diabetes, and lists the medications you're taking as well as an explanation of how to use them. The letter should include the names of pills, types of insulin, when and how to take them and any other required diabetic supplies that you'll be taking with you.
- Fill out an extra prescription for each medication and diabetic supply you'll be taking on your trip.
What you can do…
- Double the amount of diabetic supplies you think you'll need for the time you will be away. Put half of those supplies in your suitcase and the other half, with all your medications, in a carry-on bag that you should keep close at hand.
- Ensure that all of your medications and syringes have the complete, original pharmacy labels on them. If you remove those labels, you could have problems at security checkpoints.
- Carry two or three snacks with you. In addition, you should bring along a couple of bottles of juice, some hard candy and glucose tablets.
- Take care of your feet. Pack shoes, boots and socks that will not cause blisters, and check your feet on a regular basis while you are traveling.