Benefits of continuous positive airway pressure on glycaemic control and insulin resistance in patients with type 2 diabetes and obstructive sleep apnoea: A meta‐analysis. Issue 2 (2nd December 2020) - Shang, Wenli
Abstract: Aim: To conduct a meta‐analysis to determine the effects of continuous positive airway pressure (CPAP) treatment on glycaemic control and insulin resistance in patients with type 2 diabetes and obstructive sleep apnoea (OSA). Methods: A systematic search was made of the MEDLINE, SCOPUS, ISI Web of Science, Cochrane databases, and clinicaltrials.gov, without language restrictions. Randomized controlled trials on treatment of type 2 diabetes and OSA with CPAP, compared with sham CPAP or no CPAP, were reviewed. Studies were pooled to obtain standardized mean differences (SMDs), with 95% confidence intervals (CIs). Results: Seven trials (enrolling 691 participants) met the inclusion criteria. CPAP showed significant effects on glycated haemoglobin (HbA1c; SMD −0.32, 95% CI −0.60 to −0.03; P = 0.029), fasting glucose (SMD −0.39, 95% CI −0.76 to −0.02; P = 0.040), homeostatic model assessment of insulin resistance (HOMA‐IR; SMD −1.05, 95% CI −1.91 to −0.19; P = 0.016), systolic blood pressure (SMD −1.18, 95% CI −2.29 to −0.07 mm Hg; P = 0.037), and diastolic blood pressure (SMD −1.29, 95% CI −2.48 to −0.09; P = 0.035). Conclusions: Continuous positive airway pressure treatment significantly improved glycaemic control and insulin resistance, as shown by the decreased HbA1c levels, fasting glucose levels and HOMA‐IR values in patients with type 2 diabetes and OSA.