Published online Dec 15, 2013. doi: 10.4239/wjd.v4.i6.238
Revised: November 5, 2013
Accepted: November 15, 2013
Published online: December 15, 2013
Obstructive sleep apnea (OSA) is frequently associated with obesity and metabolic syndrome. Also frequently associated with metabolic syndrome is type 2 diabetes mellitus (T2DM). Therefore, it is common to find OSA and T2DM together in individuals with metabolic syndrome. Additionally, both OSA and T2DM have a common pathophysiological link with development of insulin resistance. Individuals with severe insulin resistance are likely to have inadequate glycemic control. Long standing poorly controlled T2DM is associated with debilitating microvascular complications such as retinopathy, nephropathy, neuropathy and macrovascular complications such as coronary artery and cerebrovascular disease. There is extensively published literature exploring the cause-effect relationship between OSA and T2DM. In this article we provide an in-depth review of the complex pathophysiological mechanisms linking OSA to T2DM. Specifically, this review focusses on the effect of OSA on the microvascular complications of T2DM such as retinopathy, nephropathy and neuropathy. Additionally, we review the current literature on the effect of continuous positive airway pressure use in individuals with T2DM and OSA.
Core tip: This manuscript addresses the effect of obstructive sleep apnea (OSA) on type 2 diabetes (T2DM) and its associated vascular complications. Specifically, this article provides a comprehensive review of the association between OSA and the microvascular complications of T2DM. Finally, a summary of the effect of the use of continuous positive airway pressure treatment in individuals with OSA and T2DM is reviewed.