Obstructive sleep apnoea: what are the risk factors for patients with type 2 diabetes?

  • Subramanian A & al.
  • Diabetes Care
  • 12 Mar 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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  • Patients with type 2 diabetes mellitus (T2DM) are at increased risk of developing obstructive sleep apnoea (OSA) vs those without T2DM.
  • In addition to known predictors of OSA, insulin treatment and diabetes-related foot disease were identified as risk factors in patients with T2DM.

Why this matters

  • Physicians should assess OSA in patients with T2DM, mainly in men, and patients with high BMI, hypertension, depression, cardiovascular disease, diabetes-related foot disease and those with prescribed insulin.

Study design

  • An age-, sex- and BMI-matched controlled retrospective cohort study was conducted using data from the Health Improvement Network to compare the incidence of OSA in patients with T2DM and those without diabetes.
  • Funding: None disclosed.

Key results

  • OSA developed in 3110 patients (0.88%) with diabetes and in 5968 control patients (0.46%).
  • Adjusted incidence rate ratio (aIRR) of OSA in patients with T2DM vs those without was 1.48 (95% CI, 1.42-1.55; P<.001>
  • Factors significantly predictive of incident OSA in patients with T2DM were:
    • male sex (aIRR, 2.27; 95% CI, 2.09-2.46),
    • being overweight (aIRR, 2.02; 95% CI, 1.54-2.64) or obese (aIRR, 8.29; 95% CI, 6.42-10.69),
    • diabetes-related foot disease (aIRR, 1.23; 95% CI, 1.06-1.42),
    • insulin prescription (aIRR, 1.58; 95% CI, 1.42-1.75),
    • heart failure (aIRR, 1.41; 95% CI, 1.18-1.70),
    • ischaemic heart disease (aIRR, 1.22; 95% CI, 1.11-1.34),
    • atrial fibrillation (aIRR, 1.23; 95% CI, 1.04-1.46),
    • hypertension (aIRR, 1.32; 95% CI, 1.23-1.43) and
    • depression (aIRR, 1.75; 95% CI, 1.61-1.91).


  • Risk of potential bias.

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