Effect of 12-week continuous positive airway pressure therapy on glucose levels assessed by continuous glucose monitoring in people with type 2 diabetes and obstructive sleep apnoea; a randomized controlled trial

Anne Margareta Banghøj; Christoffer Krogager; Peter Lommer Kristensen; Klavs Würgler Hansen; Esben Laugesen; Jesper Fleischer; Simon Lebech Cichosz; Per Løgstrup Poulsen; Martin Glymer Kirkegaard; Birger Thorsteinsson; Lise Tarnow

doi:10.1002/edm2.148

Effect of 12-week continuous positive airway pressure therapy on glucose levels assessed by continuous glucose monitoring in people with type 2 diabetes and obstructive sleep apnoea; a randomized controlled trial

Anne Margareta Banghøj^*, Christoffer Krogager, Peter Lommer Kristensen, Klavs Würgler Hansen, Esben Laugesen, Jesper Fleischer, Simon Lebech Cichosz, Per Løgstrup Poulsen, Martin Glymer Kirkegaard, Birger Thorsteinsson, Lise Tarnow

^*Corresponding author for this work

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Abstract

Aim: Obstructive sleep apnoea (OSA) is frequent in type 2 diabetes (T2D). The aim was to investigate the effect of a 12-week treatment with continuous positive airway pressure (CPAP) on glycaemic control assessed by continuous glucose monitoring (CGM), HbA1c and fasting blood glucose in patients with T2D and newly detected OSA. Methods: In a randomized controlled multicentre study, 72 participants with T2D and moderate to severe OSA (78% male, age 62 ± 7, AHI 35 ± 15) were recruited from outpatient clinics in three Danish hospitals and were randomized to CPAP intervention or control. The main outcome was glycaemic control assessed by 6 days CGM at baseline and after 12-week therapy, as well as by HbA1c and fasting blood glucose. Results: No significant changes were found in average glucose levels, time in glucose range, time with hypoglycaemia, time with hyperglycaemia or coefficient of variability. HbA1c decreased 0.7 mmol/mol (0.07%; P =.8) in the CPAP group and increased 0.8 mmol/mol (0.08%; P =.6) in the control group (intergroup difference, P =.6). Fasting blood glucose increased by 0.2 mmol/L (P =.02) in the CPAP group and by 0.4 mmol/L (P =.01) in the control group (intergroup difference, P =.7). In a prespecified subgroup analysis comparing participants with high adherence (minimum usage of four hours/night for 70% of all nights) to CPAP to the control group, no significant changes were observed either, although these participants had a tendency towards better glycaemic indices. Conclusions: CPAP treatment for 12 weeks does not significantly change glycaemic control in patients with type 2 diabetes and OSA.

Original language	English
Article number	e00148
Journal	Endocrinology, Diabetes & Metabolism
Volume	4
Issue	2
Number of pages	11
ISSN	2398-9238
DOIs	https://doi.org/10.1002/edm2.148
Publication status	Published - Apr 2021

Keywords

continuous glucose monitoring
continuous positive airway pressure
obstructive sleep apnoea
type 2 diabetes

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Banghøj, A. M., Krogager, C., Kristensen, P. L., Hansen, K. W., Laugesen, E., Fleischer, J., Lebech Cichosz, S., Poulsen, P. L., Glymer Kirkegaard, M., Thorsteinsson, B., & Tarnow, L. (2021). Effect of 12-week continuous positive airway pressure therapy on glucose levels assessed by continuous glucose monitoring in people with type 2 diabetes and obstructive sleep apnoea; a randomized controlled trial. Endocrinology, Diabetes & Metabolism, 4(2), Article e00148. https://doi.org/10.1002/edm2.148

@article{20bb6328ec174990a9ad27b96bbd934f,

title = "Effect of 12-week continuous positive airway pressure therapy on glucose levels assessed by continuous glucose monitoring in people with type 2 diabetes and obstructive sleep apnoea; a randomized controlled trial",

abstract = "Aim: Obstructive sleep apnoea (OSA) is frequent in type 2 diabetes (T2D). The aim was to investigate the effect of a 12-week treatment with continuous positive airway pressure (CPAP) on glycaemic control assessed by continuous glucose monitoring (CGM), HbA1c and fasting blood glucose in patients with T2D and newly detected OSA. Methods: In a randomized controlled multicentre study, 72 participants with T2D and moderate to severe OSA (78% male, age 62 ± 7, AHI 35 ± 15) were recruited from outpatient clinics in three Danish hospitals and were randomized to CPAP intervention or control. The main outcome was glycaemic control assessed by 6 days CGM at baseline and after 12-week therapy, as well as by HbA1c and fasting blood glucose. Results: No significant changes were found in average glucose levels, time in glucose range, time with hypoglycaemia, time with hyperglycaemia or coefficient of variability. HbA1c decreased 0.7 mmol/mol (0.07%; P =.8) in the CPAP group and increased 0.8 mmol/mol (0.08%; P =.6) in the control group (intergroup difference, P =.6). Fasting blood glucose increased by 0.2 mmol/L (P =.02) in the CPAP group and by 0.4 mmol/L (P =.01) in the control group (intergroup difference, P =.7). In a prespecified subgroup analysis comparing participants with high adherence (minimum usage of four hours/night for 70% of all nights) to CPAP to the control group, no significant changes were observed either, although these participants had a tendency towards better glycaemic indices. Conclusions: CPAP treatment for 12 weeks does not significantly change glycaemic control in patients with type 2 diabetes and OSA.",

keywords = "continuous glucose monitoring, continuous positive airway pressure, obstructive sleep apnoea, type 2 diabetes",

author = "Bangh{\o}j, {Anne Margareta} and Christoffer Krogager and Kristensen, {Peter Lommer} and Hansen, {Klavs W{\"u}rgler} and Esben Laugesen and Jesper Fleischer and {Lebech Cichosz}, Simon and Poulsen, {Per L{\o}gstrup} and {Glymer Kirkegaard}, Martin and Birger Thorsteinsson and Lise Tarnow",

year = "2021",

month = apr,

doi = "10.1002/edm2.148",

language = "English",

volume = "4",

journal = "Endocrinology, Diabetes & Metabolism",

issn = "2398-9238",

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number = "2",

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Banghøj, AM, Krogager, C, Kristensen, PL, Hansen, KW , Laugesen, E , Fleischer, J, Lebech Cichosz, S, Poulsen, PL, Glymer Kirkegaard, M, Thorsteinsson, B & Tarnow, L 2021, 'Effect of 12-week continuous positive airway pressure therapy on glucose levels assessed by continuous glucose monitoring in people with type 2 diabetes and obstructive sleep apnoea; a randomized controlled trial', Endocrinology, Diabetes & Metabolism, vol. 4, no. 2, e00148. https://doi.org/10.1002/edm2.148

Effect of 12-week continuous positive airway pressure therapy on glucose levels assessed by continuous glucose monitoring in people with type 2 diabetes and obstructive sleep apnoea; a randomized controlled trial. / Banghøj, Anne Margareta; Krogager, Christoffer; Kristensen, Peter Lommer et al.
In: Endocrinology, Diabetes & Metabolism, Vol. 4, No. 2, e00148, 04.2021.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Effect of 12-week continuous positive airway pressure therapy on glucose levels assessed by continuous glucose monitoring in people with type 2 diabetes and obstructive sleep apnoea; a randomized controlled trial

AU - Banghøj, Anne Margareta

AU - Krogager, Christoffer

AU - Kristensen, Peter Lommer

AU - Hansen, Klavs Würgler

AU - Laugesen, Esben

AU - Fleischer, Jesper

AU - Lebech Cichosz, Simon

AU - Poulsen, Per Løgstrup

AU - Glymer Kirkegaard, Martin

AU - Thorsteinsson, Birger

AU - Tarnow, Lise

PY - 2021/4

Y1 - 2021/4

N2 - Aim: Obstructive sleep apnoea (OSA) is frequent in type 2 diabetes (T2D). The aim was to investigate the effect of a 12-week treatment with continuous positive airway pressure (CPAP) on glycaemic control assessed by continuous glucose monitoring (CGM), HbA1c and fasting blood glucose in patients with T2D and newly detected OSA. Methods: In a randomized controlled multicentre study, 72 participants with T2D and moderate to severe OSA (78% male, age 62 ± 7, AHI 35 ± 15) were recruited from outpatient clinics in three Danish hospitals and were randomized to CPAP intervention or control. The main outcome was glycaemic control assessed by 6 days CGM at baseline and after 12-week therapy, as well as by HbA1c and fasting blood glucose. Results: No significant changes were found in average glucose levels, time in glucose range, time with hypoglycaemia, time with hyperglycaemia or coefficient of variability. HbA1c decreased 0.7 mmol/mol (0.07%; P =.8) in the CPAP group and increased 0.8 mmol/mol (0.08%; P =.6) in the control group (intergroup difference, P =.6). Fasting blood glucose increased by 0.2 mmol/L (P =.02) in the CPAP group and by 0.4 mmol/L (P =.01) in the control group (intergroup difference, P =.7). In a prespecified subgroup analysis comparing participants with high adherence (minimum usage of four hours/night for 70% of all nights) to CPAP to the control group, no significant changes were observed either, although these participants had a tendency towards better glycaemic indices. Conclusions: CPAP treatment for 12 weeks does not significantly change glycaemic control in patients with type 2 diabetes and OSA.

AB - Aim: Obstructive sleep apnoea (OSA) is frequent in type 2 diabetes (T2D). The aim was to investigate the effect of a 12-week treatment with continuous positive airway pressure (CPAP) on glycaemic control assessed by continuous glucose monitoring (CGM), HbA1c and fasting blood glucose in patients with T2D and newly detected OSA. Methods: In a randomized controlled multicentre study, 72 participants with T2D and moderate to severe OSA (78% male, age 62 ± 7, AHI 35 ± 15) were recruited from outpatient clinics in three Danish hospitals and were randomized to CPAP intervention or control. The main outcome was glycaemic control assessed by 6 days CGM at baseline and after 12-week therapy, as well as by HbA1c and fasting blood glucose. Results: No significant changes were found in average glucose levels, time in glucose range, time with hypoglycaemia, time with hyperglycaemia or coefficient of variability. HbA1c decreased 0.7 mmol/mol (0.07%; P =.8) in the CPAP group and increased 0.8 mmol/mol (0.08%; P =.6) in the control group (intergroup difference, P =.6). Fasting blood glucose increased by 0.2 mmol/L (P =.02) in the CPAP group and by 0.4 mmol/L (P =.01) in the control group (intergroup difference, P =.7). In a prespecified subgroup analysis comparing participants with high adherence (minimum usage of four hours/night for 70% of all nights) to CPAP to the control group, no significant changes were observed either, although these participants had a tendency towards better glycaemic indices. Conclusions: CPAP treatment for 12 weeks does not significantly change glycaemic control in patients with type 2 diabetes and OSA.

KW - continuous glucose monitoring

KW - continuous positive airway pressure

KW - obstructive sleep apnoea

KW - type 2 diabetes

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U2 - 10.1002/edm2.148

DO - 10.1002/edm2.148

M3 - Journal article

C2 - 33855195

AN - SCOPUS:85089075657

SN - 2398-9238

VL - 4

JO - Endocrinology, Diabetes & Metabolism

JF - Endocrinology, Diabetes & Metabolism

IS - 2

M1 - e00148

ER -

Banghøj AM, Krogager C, Kristensen PL, Hansen KW , Laugesen E , Fleischer J et al. Effect of 12-week continuous positive airway pressure therapy on glucose levels assessed by continuous glucose monitoring in people with type 2 diabetes and obstructive sleep apnoea; a randomized controlled trial. Endocrinology, Diabetes & Metabolism. 2021 Apr;4(2):e00148. Epub 2020 Aug. doi: 10.1002/edm2.148

Effect of 12-week continuous positive airway pressure therapy on glucose levels assessed by continuous glucose monitoring in people with type 2 diabetes and obstructive sleep apnoea; a randomized controlled trial

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