“Patients with type 2 diabetes and obstructive sleep apnea (OSA) are at increased risk of developing advanced retinopathy and also are at increased risk of greater decline in kidney function, as we found in a previous publication,” senior study author Dr. Abd A. Tahrani from University of Birmingham told Reuters Health.
“Hence, diagnosing OSA offers the opportunity to identify a high-risk group of patients which will allow doctors to apply preventative treatment strategy to slow the progression of these complications,” Tahrani said by email.
Sleep apnea treatment with CPAP (continuous positive airway pressure) has shown effectiveness at slowing the progression to advanced diabetic retinopathy.
“While the impact of CPAP on retinopathy and other diabetes-related complications requires further study, CPAP treatment has several benefits, including lowering the blood pressure, improving sleepiness, improving quality of life, improving OSA-related symptoms and reducing the risk of road traffic accidents; hence CPAP treatment should be considered in patients with type 2 diabetes who have OSA,” Tahrani said.
“Diabetic retinopathy is mostly caused by diabetes, and more severe diabetic retinopathy could be promoted by poor blood sugar control and OSA in type 2 diabetes,” said Dr. Gen-Min Lin from Hualien-Armed Forces General Hospital and National Dong Hwa University in Hualien, Taiwan, who recently looked at the association of sleep apnea with changes in the tiny blood vessels of the retina.
“In some cross-sectional studies, women with more severe OSA were found to have higher risk of less severe diabetic retinopathy (such as microaneurysms) than men,” Lin told Reuters Health in an email. “This sex difference might be related to female sex hormone or higher grade inflammation status in women.”
SOURCE: bit.ly/2utX8Qz American Journal of Respiratory and Critical Care Medicine, online June 8, 2017.