Endocrine Abstracts

Introduction: Obstructive sleep apnoea (OSA) is common in people with type 2 diabetes mellitus (T2DM), with prevalence ranging from 20-50% and up to 85% in obese T2DM. However, OSA remains largely undiagnosed due to the high cost of testing and limited availability of sleep clinics, particularly in developing countries. The aim of this study is to determine the prevalence of type 2 diabetic patients at high risk of OSA and to identify factors associated with OSA in this population.

Methods: A cross-sectional study was conducted on 130 patients with T2DM who were hospitalized in the Endocrinology Department of the National Institute of Nutrition and Food Technology in Tunis. The inclusion criteria were patients aged 30 years or older with T2DM diagnosed for at least 2 years. The study excluded patients with known OSA, any endocrinopathy that could be the cause of OSA, acute respiratory failure, acute or chronic bronchopneumonia, or bronchopulmonary tumour pathology. Screening for OSA was conducted using the Berlin questionnaire and the ApneaLink sleep screening device.

Results: The mean age of the patients was 59.37±7.80 years, with a female predominance (63.1%). Hypertension was present in 68% of cases. The mean BMI of the patients was 30.53±5.16 kg/m². The mean waist circumference was 101.23±13.3 cm. Fat distribution was android in 96.34% of women and 52% of men. The mean neck circumference was 39.51±3.11 cm. The mean duration of diabetes was 12.54±7.81 years. The mean HbA1c was 11.15±1.82%. According to the Berlin questionnaire, 62.3% of the population were at high risk of OSA, and according to the Apnealink device, 61% had an AHI ≥ 5/h and 20% an AHI ≥ 15/h. The factors associated with high risk of OSA in our study were: Age (P=0.036), female gender (P=0.011) and BMI (P=0.013) especially android fat distribution (P=0.03), high fasting glucose (P=0.046), hypercholesterolaemia (P=0.013) and diabetic nephropathy (P=0.010). In terms of functional signs, snoring (P=0.024), insomnia (P=0.048), chronic fatigue (P=0.011) and memory problems (P=0.017) were also associated with a high risk of OSAHS. Multivariate analysis showed a positive and statistically significant association with a high risk of OSAS for: female sex (P=0.045), fasting plasma glucose (P=0.038)) and diabetic nephropathy (P=0.012)

Conclusion: OSA is often associated with T2DM. Systematic screening for OSA in these patients is essential, especially in the presence of android obesity and poorly controlled diabetes.