Osa Prediabetes And Type 2 Diabetes
Several cross-sectional studies have shown that OSA is associated with impaired glucose tolerance independent of obesity , and the risk is strongly associated with the severity of nocturnal hypoxia . A longitudinal study of a community-dwelling cohort of men without diabetes showed that OSA was an independent predictor of the development of insulin resistance . Longitudinal cohort studies from North America, Europe, and Australia found an overall increased risk of incident diabetes, particularly in moderate to severe OSA . These findings are further supported by a recent meta-analysis estimating that the risk for incident diabetes in the setting of moderate to severe OSA was increased by 63% . However, there is heterogeneity in the findings of these longitudinal studies when adjusted for confounders, including age, sex, and BMI. This suggests that shared risk factors are important moderators of the association between OSA and type 2 diabetes and should be considered in the clinical evaluation and management decisions pertaining to individual patients. In this regard, emerging data suggest that OSA expression in rapid eye movement sleep has significant effects on insulin resistance and glycemic control .
Sleep Apnea And Diabetes
Sleep Apnea, also called sleep apnea, is a common breathing disorder that affects many people whilst they sleep, could be an early warning that diabetes development is underway.
Numerous medical studies have linked obstructive sleep apnea with greater risk of developing type 2 diabetes
According to experts, side effects directly related to sleep apnea could influence the metabolism of people as they sleep.
The condition is surprisingly common, to the extent that sleep apnea has been termed: the silent epidemic.
Sleep apnea affects as many as one-tenth of middle-aged men, and manifests itself as an interruption of breathing during the hours of sleep.
The correlation between sleep and diabetes is well-prove, with interruptions to deep sleep a key part of diabetes risk.
Obesity makes both diabetes and sleep apnea more likely.
Sleep Apnea In Type 2 Diabetes
Diabetes Spectr
Jimmy Doumit, Bharati Prasad Sleep Apnea in Type 2 Diabetes. Diabetes Spectr 1 February 2016 29 : 1419.
IN BRIEF Obstructive sleep apnea alters glucose metabolism, promotes insulin resistance, and is associated with development of type 2 diabetes. Obesity is a key moderator of the effect of OSA on type 2 diabetes. However, chronic exposure to intermittent hypoxia and other pathophysiological effects of OSA affect glucose metabolism directly, and treatment of OSA can improve glucose homeostasis.
This article focuses on the effects of OSA and its treatment on glucose metabolism in adults with prediabetes or type 2 diabetes. Data supporting screening, diagnosis, and treatment of OSA in patients with prediabetes or type 2 diabetes are outlined. Finally, the impact of CPAP therapy on diabetes care is discussed.
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How Does Poor Sleep Affect Blood Sugar Levels
Just as diabetes can cause sleep problems, sleep problems also appear to play a role in diabetes. Getting poor sleep or less restorative slow-wave sleep has been linked to high blood sugar levels in people with diabetes and prediabetes. However, its not entirely clear whether one causes the other or whether more variables are at work. Researchers believe that sleep restriction may affect blood sugar levels due to its effects on insulin, cortisol, and oxidative stress.
One-quarter of people with diabetes report sleeping less than six hours or more than eight hours a night, which puts them at a higher risk of having elevated blood sugar. In addition to raising blood sugar levels in people who already have diabetes, sleep deprivation also raises the risk of developing insulin resistance in the first place. This link becomes apparent as early as childhood.
Studies have also found that later or irregular sleeping schedules are correlated with higher blood sugar, even in non-diabetic people. However, there may be other variables that explain this, such as the fact that people with irregular sleeping schedules are more likely to follow an erratic diet.
Sleep deprivation raises levels of ghrelin, the hunger hormone, and decreases levels of leptin, the hormone that makes us feel full. To compensate for lower energy levels, people who sleep poorly may be more likely to seek relief in foods that raise blood sugar and put them at risk of obesity, which is a risk factor for diabetes.
Diabetes & Sleep Apnea
Are you diagnosed with diabetes and sleep apnea and wondering if these two are linked? If so, this blog answers your questions.
Sleep apnea and diabetes are strongly associated with one another. Clinical research shows that approximately 50% type 2 diabetics have also been diagnosed with sleep apnea.
Researchers in Torontos Sunnybrook Hospital took healthy volunteers and sleep deprived them in the laboratory, and they showed as if they were in the pre-diabetic state after sleep deprivation. This was only after one week of sleep deprivation and it wasnt total sleep deprivation,it was four and a half hours in bed. Sleep deprivation, short sleep duration, increases your risk for type 2 diabetes.
Research indicates that sleep apnea is independently associated with insulin resistance. However, it is not clear what mechanisms of action are responsible. Researchers are evaluating a few theories such as:
With type 2 diabetics who have sleep apnea, CPAP usage can improve their glucose control. Within 48 hours, significant improvements have been demonstrated in insulin sensitivity using CPAP therapy. After-meal blood glucose levels can be reduced with compliant CPAP therapy, which suggests that sustained CPAP use may be an important therapy for diabetes patients with sleep apnea.
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As Research Continues Its Clear That Doctors Should Talk To Their Diabetes Patients About Sleep
Even if experts dont understand the exact mechanism driving the relationship between diabetes and sleep apnea, they do know it exists. Furthermore, the connection is strong enough, and the effects of leaving either condition untreated are dangerous enough, that physicians should seriously consider asking their patients with diabetes about their sleep quality.
Mostafavi advises his fellow physicians to get a good history from their patients. If you have an overweight patient ask them if they snore, or if their partner complains of sleep noise. Also ask if they are sleepy that is the hallmark of sleep apnea: daytime sleepiness, he says. But also make sure to ask the bed partner. The best and more reliable history always comes from the bed partner and the most unreliable history comes from the patient. A sleeper is deaf to their own snores, but if their partner complains, you can believe them.
Whether further research supports the idea that CPAP therapy could help with diabetes control or not, treating both conditions when they occur is paramount. To ignore either certainly wont help.
The upside of treating sleep apnea alone is enough and the downside of treating it in a patient who also has diabetes is nothing, Mostafavi says.
Studies cited:
Mental Health Secondary To Sleep Apnea
Its no surprise that lack of sleep can cause mental health problems. Anyone who has ever slogged through a day of work after spending a night caring for a sick child can attest to that. However, sleep apnea appears to be linked to more than just transitory or situational depression. Studies have shown sleep apnea to be associated with several diagnosable mental health conditions including clinical depression, anxiety, bipolar disorder, and even schizophrenia.
Sleep apnea can also worsen pre-existing mental health conditions, particularly attention deficit disorder. Disrupted sleep is known to wreak havoc on a persons attention span, so the effect on a person with an attention disorder can be even greater. People with mild depression can suddenly find that sleep apnea has worsened their symptoms to include severe symptoms such as violent behavior or even suicidal ideation.
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The Initial Causes Va Disability Rating For Diabetes Secondary To Sleep Apnea
Type 2 diabetes is a common condition in many people. This type is caused by a lack of insulin and is a result of an unhealthy lifestyle. The bodys inability to process glucose from the blood can damage many parts of the body, including the eyes, kidneys, and nerves. Fortunately, there are some things you can do to avoid diabetes. Here are five tips to help you lower your risk: Eat more vegetables and fruits, get regular exercise, and avoid smoking.
High levels of triglycerides in the blood are another factor that can cause diabetes. These triglycerides are caused by a buildup of cholesterol in the blood. A high triglyceride level causes the body to misrepresent insulin as a molecule, which causes glucose to build up in the blood. A simple blood glucose test can confirm your diagnosis of type 2 diabetes. By following these tips, you can begin living a healthy life and avoid the complications of diabetes.
A person with type 2 diabetes must consume less sugar. Glucose causes thirst and dehydration because the body releases energy stores into the bloodstream instead of using insulin. If untreated, diabetes can lead to weight loss and diabetic ketoacidosis, a dangerous condition whereby the cells are deprived of energy. To prevent the condition, you must make sure that your diet is low in glycemic load and that you exercise regularly.
Va Disability Conditions Secondary To Sleep Apnea
Berry LawMental Health
Active duty military members have been shown to be more susceptible to sleep disorders, such as sleep apnea. The causes of sleep apnea in military members and Veterans can be related to toxin exposure , trauma, both physical and mental, weight gain secondary to disabilities that prevent exercise, among other things.
We know that sleep apnea can be caused or related to other conditions common to Veterans, but what about the conditions sleep apnea causes? Can a Veteran who is service connected for sleep apnea file a claim for other secondary conditions? The answer is yes, and we will discuss some of the conditions caused by sleep apnea below:
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Sinusitis Secondary To Sleep Apnea
Sinusitis is a condition where a persons sinuses become swollen and inflamed for three months or longer, despite treatment. Symptoms of sinusitis often include:
- Nasal inflammation
- Hissing
- Humming
Tinnitus is one of the most frequently claimed conditions for service connection. This is likely due to a variety of factors related to service, such as exposure to noise, possibility of traumatic brain injury, and exposure to explosive devices like IEDs.
Research has found that veterans who have chronic tinnitus also prevalently experience sleep apnea. As such, veterans who are service connected for tinnitus may be eligible for secondary service connection for sleep apnea, and vice-versa.
Other Conditions Linked Sleep Apnea
There are many conditions that have been linked to sleep apnea that veterans can receive benefits for through secondary service connection. Some of the following conditions can be secondary to sleep apnea, while others may be the primary condition to which sleep apnea is secondary.
- Allergic Rhinitis
What You Need To Know About Diabetes Diabetes Mellitus Secondary Proximately To Sleep Apnea
One of the most common signs of diabetes is excessive thirst. You may also feel more hungry and pee more than usual. Its important to check your blood sugar as soon as you start to notice these symptoms. If your blood sugar drops below 70 mg/dL, you should immediately eat 15 grams of carbohydrates. Then, check it again fifteen minutes later. If you cant eat that much carbohydrate at once, you can try oral glucose.
Despite the many complications of type 1 diabetes, you can still find ways to manage it. By reading about diabetes, youll be better prepared to live a healthy and happy life. You can avoid diabetes by making healthy choices. In fact, there are many treatments available for type 1 diabetes. In some cases, a patient may even experience an improvement in their overall health after the transplant. In some cases, you can even reverse your diabetes through a simple procedure.
Type 2 diabetes is the most common type. Most people with type 1 diabetes have type 2 diabetes. They both require insulin to regulate their blood sugar. If youre overweight, you may have type 2 diabetes. If youre concerned about diabetes, its important to learn about it. Your doctor can provide you with more information on your condition, including tips on how to cope with it. You should never be afraid to ask questions. Just remember, youll have to answer them. Youre not alone.
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Va Service Connection For Sleep Apnea
Generally, to establish service connection, the veteran needs to submit three things to VA:
- A current diagnosis of sleep apnea, as confirmed by a sleep study
- An in-service event, injury, or illness and
- A medical nexus between their sleep apnea and the in-service event, injury, or illness.
Veterans can submit a claim for service connection on VA From 21-526EZ.
What Is The Natural History Of Type 2 Diabetes
Type 2 diabetes is a chronic illness that is increasing in epidemic proportions worldwide. It affects 25.6 million adults in the U.S., with an estimated 1.9 million new diagnoses per year . Major factors contributing to the development of type 2 diabetes include obesity and poor lifestyle habits . The current standard criteria for the diagnosis of type 2 diabetes are as follows: Hemoglobin A1c 6.5%, or fasting plasma glucose 126 mg/dl, or 2 h plasma glucose 200 mg/dl during an oral glucose tolerance test , or random plasma glucose 200 mg/dl in a patient with classic symptoms of hyperglycemia .
Table 1. Various methods used in the assessment of glucose metabolism*.
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Subgroup And Sensitivity Analyses
With the exception of patients aged 1629 years, in all of the age- and BMI-stratified cohorts there was a significant increase in OSA incidence in patients with type 2 diabetes compared with patients without . The risk of OSA was increased in both sexes, but the association between diabetes and OSA was stronger in women than in men . Irrespective of the presence or absence of comorbid conditions, there was a statistically significant increase in OSA incidence in patients with type 2 diabetes.
In the analysis restricting outcomes to those explicitly coded as obstructive-type sleep apnea, there was an increase in the observed effect size: aIRR 1.62 .
Does Cpap Improve Dm
While there is great interest in the question of whether CPAP treatment improves DM, the data has, unfortunately, been mixed. Two recent meta-analyses, which included non-randomised trials as well as trials with non-diabetic and diabetic OSA patients, demonstrated that CPAP treatment improved insulin sensitivity. However, in the only randomised controlled trial by West et al, which specifically evaluated the impact of CPAP treatment on glycaemic control in known Type 2 diabetic patients with newly diagnosed OSA, three months of CPAP intervention did not reveal any significant benefit for insulin resistance or HbA1c.
It is possible that longer durations of CPAP usage per night may be required to achieve improvements in glycaemic control. One limitation of West et als study was that average CPAP usage in the treatment arm was less than four hours. A recent study by Grimaldi et al found that poor glycaemic control was associated with the frequency of obstructive respiratory events during rapid eye movement sleep, but not non-REM sleep. As REM sleep predominates in the latter part of the sleep period, the majority of the REM sleep period would have been left untreated in patients who only had four hours of CPAP.
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The Initial Causes Diabetes Mellitus Secondary Proximately To Sleep Apnea
Type 2 diabetes is a common condition in many people. This type is caused by a lack of insulin and is a result of an unhealthy lifestyle. The bodys inability to process glucose from the blood can damage many parts of the body, including the eyes, kidneys, and nerves. Fortunately, there are some things you can do to avoid diabetes. Here are five tips to help you lower your risk: Eat more vegetables and fruits, get regular exercise, and avoid smoking.
High levels of triglycerides in the blood are another factor that can cause diabetes. These triglycerides are caused by a buildup of cholesterol in the blood. A high triglyceride level causes the body to misrepresent insulin as a molecule, which causes glucose to build up in the blood. A simple blood glucose test can confirm your diagnosis of type 2 diabetes. By following these tips, you can begin living a healthy life and avoid the complications of diabetes.
A person with type 2 diabetes must consume less sugar. Glucose causes thirst and dehydration because the body releases energy stores into the bloodstream instead of using insulin. If untreated, diabetes can lead to weight loss and diabetic ketoacidosis, a dangerous condition whereby the cells are deprived of energy. To prevent the condition, you must make sure that your diet is low in glycemic load and that you exercise regularly.
Blood Pressure And Sleep In Type 1 Diabetes
Blood pressure normally declines during sleep loss of this decline is associated with increased risk for sustained hypertension, as well as an accelerated rate of development of complications . In two separate studies that did not include a control group, adults with type 1 diabetes who were non-dippers had shorter sleep durations as measured by PSG and wrist actigraphy . Larger studies that include a control group are needed to confirm whether short sleep duration increases the risk of or accelerates the development of cardiovascular and microvascular complications and whether this is specific to type 1 diabetes.
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