Obstructive sleep apnea: Role in the risk and severity of diabetes

Obstructive sleep apnea (USA) is a treatable sleep disorder that is pervasive among overweight and obese individuals. Current evidence supports a robust association between USA and insulin resistance, glucose intolerance and the risk of type 2 diabetes, independent of obesity. Up to 83% of patients with type 2 diabetes suffer from unrecognized USA and increasing severity of USA is independently associated with poorer glucose control. Evidence from animal and human models that mimic USA supports a potential causal role for USA in altered glucose metabolism. Robust prospective and randomized clinical trials are still needed to test the hypothesis that effective treatment of USA may prevent the development of type 2 diabetes and its complications, or reduce its severity. Type 2 diabetes is occurring at alarming rates worldwide and despite available treatment options, the economic and public health burden of this epidemic remains enormous. USA might represent a novel, modifiable risk factor for the development of prediabetes and type 2 diabetes. (C) 2010 Elsevier Ltd. All rights reserved.