Endocrine Abstracts

Introduction

The association between Obstructive sleep apnoea (OSA) and type 2 diabetes mellitus (T2DM) is well known and this combination imposes a higher risk of complications in the affected indvidual. Polysomnography which is a gold standard for diagnosing OSA is not universally available, so many of the patients with OSA remain undiagnosed. A questionnaire-based OSA screening for risk stratification can help early detection of OSA in T2DM.

Methods

This was a cross-sectional study done in an endocrine speciality hospital in the Indian state of Punjab. The participants were 486 adult subjects with T2DM who all underwent clinical evaluation, anthropometry, investigations and were administered STOP-BANG questionnaire, which is an eight items tool with four symptoms and four signs to stratify the OSA risk. The scoring scale is categorized into three risk groups; low risk (0–2), intermediate risk (3–4) and high risk (5–8) respectively.

Results

Out of all the participants 57.3% were males. Mean age of the participants was 56.7 ± 12.8 years. STOP-BANG score of ≥  3 was present in 43.6% of the participants with moderate risk score (3–4) in 26.2% and high risk score (5–8) in 17.4% of the participants. The score showed positive correlation with age, male sex, duration of diabetes, BMI, hypertension and CAD. It was not correlated with Hba1c, use of insulin.

Discussion and conclusions

Various studies have shown high prevalence of OSA in subjects with T2DM and the presence of OSA being associated with an increased likelihood of hypertension, cardiovascular disease, diminished quality of life and increased mortality justifies the importance of screening for OSA in diabetic patients. In the present study by using a clinical tool STOP-BANG questionnaire we have found high prevalence (43.6%) of OSA in T2DM subjects and its significant correlation with age, duration of diabetes, BMI, H/T and CAD. STOP-BANG is a simple screening tool having high sensitivity and can be conveniently used in primary care setting to identify the subjects at risk of OSA. These sub-set of patients can be then subjected to polysomnography for confirmation and appropriate timely management, so as to reduce the morbidity and mortality associated with untreated OSA.