Obstructive sleep apnoea raises CV and microvascular disease risk in T2D

  • Adderley NJ & al.
  • Diabetes Care
  • 28 Apr 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • Patients with type 2 diabetes (T2D) who develop obstructive sleep apnoea (OSA) are at an increased risk of incident cardiovascular disease (CVD), microvascular complications, and mortality compared with those without a diagnosis of OSA.

Why this matters

  • Physicians need to identify that patients with T2D who develop OSA are a high-risk population and that strategies to detect OSA and prevent vascular complications should be implemented.

Study designs

  • This retrospective study included 3667 patients with T2D and a subsequent diagnosis of OSA and 10,450 matched control participants with T2D but no diagnosis of OSA using data from The Health Improvement Network (THIN) database, UK.
  • Funding: None disclosed.

Key results

  • After adjustments, patients with T2D and OSA vs control participants were at an increased risk of:
    • composite CVD (ischaemic heart disease [IHD], stroke/transient ischaemic attack [TIA], heart failure [HF])(HR, 1.54; 95% CI, 1.32-1.79);
    • IHD (HR, 1.55; 95% CI, 1.26, 1.90);
    • stroke/TIA (HR, 1.57; 95% CI, 1.27-1.94);
    • HF (HR, 1.67; 95% CI, 1.35-2.06);
    • atrial fibrillation (HR, 1.53; 95% CI, 1.28-1.83); and
    • all-cause mortality (HR, 1.24; 95% CI, 1.10-1.40).
  • Similarly, patients with T2D and OSA vs control participants were at a higher risk of:
    • peripheral neuropathy (HR, 1.32; 95% CI, 1.14-1.51);
    • diabetes-related foot disease (HR, 1.42; 95% CI, 1.16-1.74);
    • chronic kidney disease (stage 3-5; HR, 1.18; 95% CI, 1.02-1.36); and
    • albuminuria (HR, 1.11; 95% CI, 1.01-1.22).
  • No significant association was observed between OSA and the risk of peripheral vascular disease (HR, 1.10; 95% CI, 0.91-1.32) or referable retinopathy (HR, 0.99; 95% CI, 0.82- 1.21).

Limitations

  • Retrospective design.