Gouveri Evanthia, Drakopanagiotakis Fotios, Panou Theodoros, Papazoglou Dimitrios, Steiropoulos Paschalis, Papanas Nikolaos
Diabetes Centre, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece.
Department of Respiratory Medicine, Medical School, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece.
Diabetes Ther. 2025 Jun 4. doi: 10.1007/s13300-025-01756-1.
The association of sleep apnoea with insulin resistance and type 2 diabetes mellitus (T2DM) is well studied. However, little is known on the impact of sleep apnoea on glycaemic variability (GV). Continuous glucose monitoring (CGM) systems shed light on GV not only during sleep but throughout the day among people with or without diabetes mellitus (DM) and obstructive sleep apnoea syndrome (OSAS). In this narrative review, we aimed to summarise the evidence on the role of CGM in assessing GV among individuals with sleep apnoea. Articles related to CGM use among individuals with OSAS were included. Emerging data suggests a significant impact of OSAS on glucose metabolism during sleep and wakefulness. Of note, OSAS affects GV irrespective of glycaemic status. Moreover, the severity of OSAS has been associated with increased GV. As GV triggers oxidative stress, it contributes to adverse outcomes in people with diabetes and/or OSAS. Interestingly, a beneficial effect of continuous positive airway pressure (CPAP) treatment on blood glucose and on GV in individuals with both T2DM and OSAS has emerged, but evidence is conflicting. Additionally, among pregnant women with gestational diabetes and sleep-disordered breathing, CGM could detect nocturnal hyperglycaemic episodes, improving glycaemic control and perinatal outcomes. Future studies are needed to investigate the exact impact of OSAS treatment on GV.
睡眠呼吸暂停与胰岛素抵抗及2型糖尿病（T2DM）之间的关联已得到充分研究。然而，关于睡眠呼吸暂停对血糖变异性（GV）的影响却知之甚少。连续血糖监测（CGM）系统不仅能揭示睡眠期间的血糖变异性，还能反映糖尿病（DM）患者及非糖尿病患者、阻塞性睡眠呼吸暂停综合征（OSAS）患者全天的血糖变异性。在这篇叙述性综述中，我们旨在总结关于CGM在评估睡眠呼吸暂停患者血糖变异性方面作用的证据。纳入了与OSAS患者使用CGM相关的文章。新出现的数据表明，OSAS对睡眠和清醒期间的葡萄糖代谢有显著影响。值得注意的是，无论血糖状态如何，OSAS都会影响血糖变异性。此外，OSAS的严重程度与血糖变异性增加有关。由于血糖变异性会引发氧化应激，它会导致糖尿病患者和/或OSAS患者出现不良后果。有趣的是，持续气道正压通气（CPAP）治疗对T2DM和OSAS患者的血糖及血糖变异性产生了有益影响，但证据存在矛盾。此外，在患有妊娠期糖尿病和睡眠呼吸障碍的孕妇中，CGM可以检测到夜间高血糖发作，改善血糖控制和围产期结局。未来需要开展研究来调查OSAS治疗对血糖变异性的确切影响。
