Endocrine Abstracts

Type 2 diabetes mellitus (DM2) is often associated with obstructive sleep apnea (OSA), according to the literature. Current approach in choosing the hypoglycemic therapy is based on individualization, but do not take into account the effect on OSA. The research purpose: to evaluate the effect of various hypoglycemic agents on the characteristics of OSA in patients with type 2 diabetes.

Materials and methods: The study included patients with OSA and DM2, that were divided into 2 groups depending on hypoglycemic therapy (without CPAP therapy). Group 1 (n = 12) included patients using metformin+ gliclazide MR in treatment and group 2 (n = 14) included treatment using empagliflozin + metformin. During the study, all patients were twice monitored for glycated hemoglobin (HBA1c), weight, body mass index (BMI), polysomnographic indicators (PSG) (SOMNOlab2, Weinmann R&K (Germany)). Patients follow-up was 6 months.

Results: Patients of groups 1 and 2 are comparable in terms of experience of DM2 (6.0 [5.0; 8.0] vs 7.5 [5.9; 8.1] years), age (43.0 [37.0; 46.0] vs 45.0 [39.0; 47.0] years), (BMI) (35.0 [33.1; 36.6] vs 34.7 [33.1; 35.1] kg/m²), HBA1c (8.0 [7.6; 8.6] vs 8.3 [7.6; 8.9]%), respectively. To assess the severity of OSA according to the results of PSG, the following was defined: apnea-hypopnea index (AHI) in group 1–25.7 [23.1; 27.2] patients vs 24.1 [21.5; 25.2] patients in group 2, which corresponded to OSA of moderate severity cases. The degree of blood oxygen saturation (SpO2) 78.0 [74.1; 80.2]% vs 84.2 [75.1; 88.2]% (P = 0.05). Repeated investigations, after 6 months, demonstrate decreasing HBS1c in group 2 to 7.1%, BMI to 32.2 [30.1; 33.0] kg/m² and PSG characteristics. AHI parameter 26.8 [24, 1; 34.2] patients vs 12.0 [11.1; 14.2] patients (P = 0.02), the average duration of SA is 34.7 [29.1; 38.2] vs 14.1 [12.8; 16, 2] (P < 0.01), SpO2 –76.1 [75.1; 80.2]% vs 89.0 [88.0; 94.2]% (P < 0.02) in comparison groups 1 and 2, respectively.

Conclusion: The administration of metformin (2500 mg/day) in combination with empagliflozin (10 mg/day) treatment in patients with DM 2 and OSA for 6 months is accompanied by reduction of episodes duration and decreasing in the severity of OSA, an increasing in SpO2 and also improvement in HBA1c, decreasing in BMI.