PMID- 30073792
OWN - NLM
STAT- MEDLINE
DCOM- 20181228
LR  - 20230918
IS  - 1752-699X (Electronic)
IS  - 1752-6981 (Linking)
VI  - 12
IP  - 8
DP  - 2018 Aug
TI  - CPAP in patients with obstructive sleep apnea and type 2 diabetes mellitus: 
      Systematic review and meta-analysis.
PG  - 2361-2368
LID - 10.1111/crj.12915 [doi]
AB  - INTRODUCTION: Obstructive sleep apnea hypopnea syndrome (OSAHS) is a prevalent 
      condition across the world; it co-exists with others metabolic diseases, such as 
      central obesity, dyslipidemia, and arterial hypertension. These associations 
      increase the cardiovascular risk and mortality. Observational studies have 
      reported a strength association between OSA and type 2 Diabetes Mellitus (T2DM) 
      and continuous positive airway pressure (CPAP) is recommended for moderate to 
      severe OSAHS. OBJECTIVE: To summarize the evidence of CPAP in T2DM patients with 
      OSAHS. METHODS: A compressive search in Medline, Cochrane, Ovids, Epistemonikos, 
      and DARE was performed. Two reviewers evaluated included studies, extracted data, 
      carried out quality assessment and summarized the result. Pooled data was 
      evaluated by meta-analysis and summaries of results and evidence grading were 
      performed through the GRADE method. RESULTS: Six randomized controlled trials 
      (RCTs), including a total of 581 participants. Treatment with CPAP showed no 
      effectiveness regarding changing glycated hemoglobin (HbA1c) levels at 12 or 24 
      weeks after treatment; (Mean difference= -0.10; Confidence interval -0.25 to 
      0.04) (GRADE: MODERATE). Subgroup analysis by adherence to CPAP (> 4 hours or < 4 
      hours) confirmed these results. Other indirect outcomes, such as change in 
      fasting glucose levels, were similar in CPAP population and placebo. DISCUSSION: 
      This systematic review and meta-analysis evaluates the evidence regarding the 
      efficacy of CPAP in patients with T2DM and OSAHS. In conclusion, CPAP does not 
      improve glycemic control measure as HbA1c.
CI  - (c) 2018 John Wiley & Sons Ltd.
FAU - Labarca, Gonzalo
AU  - Labarca G
AUID- ORCID: 0000-0002-0069-3420
AD  - Facultad de Medicina, Universidad San Sebastian, Concepcion, Chile.
AD  - Medicina Interna, Complejo Asistencial Dr. Victor Rios Ruiz, Los Angeles, Chile.
AD  - Evidence Based Medicine in Pulmonology (EBMIP) Working Group, Concepcion, Chile.
FAU - Reyes, Tomas
AU  - Reyes T
AD  - Medicina Interna, Pontificia Universidad Catolica de Chile, Santiago, Chile.
FAU - Jorquera, Jorge
AU  - Jorquera J
AD  - Evidence Based Medicine in Pulmonology (EBMIP) Working Group, Concepcion, Chile.
AD  - Centro de Enfermedades respiratorias, Clinca Las Condes, Santiago, Chile.
FAU - Dreyse, Jorge
AU  - Dreyse J
AD  - Evidence Based Medicine in Pulmonology (EBMIP) Working Group, Concepcion, Chile.
AD  - Centro de Enfermedades respiratorias, Clinca Las Condes, Santiago, Chile.
FAU - Drake, Lauren
AU  - Drake L
AD  - Medical Student, A.T. Still University Kirksville College of Osteopathic 
      Medicine, Kirksville, MO.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
PL  - England
TA  - Clin Respir J
JT  - The clinical respiratory journal
JID - 101315570
RN  - 0 (Blood Glucose)
RN  - 0 (Glycated Hemoglobin A)
SB  - IM
MH  - Aged
MH  - Blood Glucose/metabolism
MH  - Continuous Positive Airway Pressure/*adverse effects/methods
MH  - Diabetes Mellitus, Type 2/blood/*complications
MH  - Glycated Hemoglobin/metabolism
MH  - Humans
MH  - Middle Aged
MH  - Observational Studies as Topic
MH  - Quality Assurance, Health Care
MH  - Randomized Controlled Trials as Topic
MH  - Sleep Apnea, Obstructive/epidemiology/*therapy
MH  - Treatment Outcome
OTO - NOTNLM
OT  - continuous positive airway pressure [MeSH]
OT  - diabetes mellitus
OT  - glucose metabolism disorder [Mesh]
OT  - obstructive [Mesh]
OT  - sleep apnea [Mesh]
OT  - type 2 [Mesh]
EDAT- 2018/08/04 06:00
MHDA- 2018/12/29 06:00
CRDT- 2018/08/04 06:00
PHST- 2017/08/06 00:00 [received]
PHST- 2018/04/15 00:00 [revised]
PHST- 2018/05/13 00:00 [accepted]
PHST- 2018/08/04 06:00 [pubmed]
PHST- 2018/12/29 06:00 [medline]
PHST- 2018/08/04 06:00 [entrez]
AID - 10.1111/crj.12915 [doi]
PST - ppublish
SO  - Clin Respir J. 2018 Aug;12(8):2361-2368. doi: 10.1111/crj.12915.