hands pricking finger to test insulin levelsHave you just been diagnosed with Type II Diabetes?  And if so, would you ever think it could be related to your Obstructive Sleep Apnea (OSA)?  According to recent studies, the majority of people with Type II Diabetes also have Sleep Apnea.  Out of those suffering from Diabetes, many have undiagnosed OSA, which leads to even more health complications.

According to the CDC (Center for Disease Control), Diabetes affects 25.6 million adults today, with an estimated 1.9 million new diagnoses per year.
The 2 different types of Diabetes are as follows:
Type I – the result of an immune system malfunction wherein the body destroys cells that produce insulin; diagnosed at a young age
Type II – when your body is not able to use insulin the right way; typically diagnosed in adulthood, although with increases in childhood obesity, Type II is becoming more prevalent at a younger age

Two main characteristics of OSA, oxygen deprivation and sleep fragmentation, can affect the metabolism in negative ways.  Reduced sleep can cause changes in the way your body processes glucose, increasing your risk of developing Type II Diabetes.  Diabetes increases the risk of neuropathy in the nervous system, which may lead to dysfunction of upper airway muscles and increased risk of OSA.
Side effects of OSA like chronic fatigue and depression lead to a more sedentary lifestyle.  This can result in obesity, limited physical activity, excess dietary intake (more unhealthy foods and sugars/carbs), and poor habits and decisions.

A vicious cycle is created because your blood sugar levels can affect your sleep, and in turn, sleep can affect your blood sugar levels. As the amount of sleep decreases, blood sugar increases, escalating the issue.

According to the CDC, 35% of U.S. adults aged 20 years or older may have Prediabetes.  Prediabetes is a condition in which blood sugar is high, but not high enough to be labeled as Type II Diabetes. The CDC estimates that approximately 70% of Prediabetic individuals eventually develop Type II Diabetes.
Weight loss is typically the first thing that is recommended, however there have been studies showing that OSA can be associated with insulin resistance and glucose intolerance independent of obesity.  Unfortunately, OSA remains unrecognized a lot of the time, so the patient is not aware of treatment options or how to better their situation. Again, this just becomes a cycle that leaves the patient unable to care for themself.

Interactions between OSA, Diabetes and Obesity are very complex and the public needs to have a better understanding of the relationship among them.  The PCP in many instances overlooks OSA and Diabetes continues to be unrecognized due to comorbidities that go along with diabetic symptoms.  More emphasis needs to be placed on overall patient health, lifestyle changes, adequate sleep and healthy diets.  All of these disorders are interrelated and if everyone increases their awareness, maybe we will start seeing a decline in these types of health issues.
Dr. Klein is someone who understands the relationships of these diseases and disorders, namely Obstructive Sleep Apnea.  Effective treatment of OSA may prevent the development of Type II Diabetes, or at least reduce its severity.

Pamidi, S., & Tasali, E. (2012). Obstructive Sleep Apnea and Type 2 Diabetes: Is There a Link? Frontiers in Neurology, 3, 126.
Kono M., Tatsumi K., Saibara T., Nakamura A., Tanabe N., Takiguchi Y., Kuriyama T. (2007). Obstructive Sleep Apnea syndrome is associated with some components of metabolic syndrome. Chest 131, 1387–1392.
Van Cauter E, Mokhlesi B, Tasali E. (2008) Obstructive Sleep Apnea and Type 2 Diabetes: Interacting Epidemics. Chest 133(2): 496-506.
doi: 10.1378/chest.07-0828
Sanders, Mark et al. Sleep disordered breathing may not be an independent risk factor for diabetes, but diabetes may contribute to the occurrence of periodic breathing in sleep.
Sleep Medicine. Volume 4, Issue 4, 349 – 350.
Centers for Disease Control website
American Diabetes Association website