The impact of obstructive sleep apnea (OSA) severity on type 2 diabetes prevalence

Background: Obstructive sleep apnea (OSA) and diabetes type 2 are high prevalent diseases with major public health impact, sharing a complex relationship. Aims and Objectives: Τo evaluate the influence of OSA severity on prevalent diabetes in a large clinical population of patients. Methods: We identified a sample of 2,279 patients (mean age 55 years, 74% men) who undergone a diagnostic polysomnography and completed the Epworth sleepiness scale (ESS). We investigated the prevalence of diabetes type 2 in patients with newly diagnosed OSA and analyzed the risk of severe OSA for prevalent diabetes after adjustment for relevant confounding factors including gender, age, smoking, obesity, daytime sleepiness and comorbidities. Results: The prevalence of Diabetes in OSA patients was 19.8%, which was 4.4 times higher than that in patients without OSA (4.5%). Diabetes was more prevalent in severe (26%) and moderate (12%) OSA compared to mild OSA (5%, pl0.001 among all). Following multivariable adjustment, severe OSA remained a significant predictor for diabetes [odds ratio (95% CI) 2.922 (1.346–6343), p=0.007]. Further analysis demonstrated[s1] that severe OSA predicted prevalent diabetes mainly in younger (l60 years) [OR (95% CI) 5.246 (1.523–18.070), p=0.009] and sleepy (ESS≥10) patients [OR (95% CI) 5.726 (1.298–25.264), p=0.021]. Conclusion: Our results showed that severe OSA associated with an independent 3-time risk increase for type 2 diabetes in this large clinical patient cohort. These data suggest that there is value in systematic screening for diabetes in severe OSA patients, especially in younger and sleepy patients.