NEW YORK (Reuters Health) – Obstructive sleep apnea (OSA) is often undiagnosed, and therefore untreated, in obese patients with type 2 diabetes, according to research published in the June issue of Diabetes Care.

Dr. Gary D. Foster, lead author and director of the Center for Obesity Research and Education at Temple University, Philadelphia, Pennsylvania, told Reuters Health: “The fact that many obese patients with type 2 diabetes have sleep apnea and don’t know it is troubling given the serious medical consequences of sleep apnea.”

In the study, 306 obese patients with type 2 diabetes underwent polysomnography and provided information on sleep, such as snoring and daytime sleepiness.

“The most remarkable finding of this study is the exceedingly high prevalence of undiagnosed OSA (86.6%) among obese patients with type 2 diabetes,” Dr. Foster and colleagues report. “Equally alarming,” they add, “is the unequivocally elevated mean apnea-hypopnea index (AHI; 20.5) of this group.”

Of the 306 patients, 33.4% had mild OSA (AHI: 5-14.9), 30.5% had moderate OSA (AHI: 15-29.9), and 22.6% had severe OSA (AHI: 30 or greater).

Having a larger waist circumference, along with a higher BMI, was significantly associated with OSA, particularly severe OSA, the researchers found.

“Physicians treating obese patients with type 2 diabetes should consider the possibility of OSA, even in the absence of symptoms, especially in those with higher waist circumference and BMI,” the investigators advise.

“The high prevalence of OSA in obese patients with type 2 diabetes represents a serious public health problem and raises the possibility that some of the morbidity and mortality associated with type 2 diabetes may be attributable to undiagnosed OSA,” they conclude.

Reference:
Diabetes Care 2009.