Impact of sleep apnoea-hypopnoea syndrome on diabetic neuropathy. A systematic review

Abstract

IntroductionDiabetes mellitus and sleep apnoea-hypopnoea syndrome appear to be related, but it is not well defined whether there is an increased risk of peripheral neuropathy in patients with both diseases. For this reason, we conducted a systematic review. MethodsBibliographic search in 3 electronic databases using a predefined strategy and the PRISMA methodology. Only original studies (any type of design) published from 2000 onwards in English, French, Portuguese or Spanish were included. A study quality scale was established. ResultsTwelve articles were selected, of which six studied type 2 diabetic patients. The overall prevalence of sleep apnoea-hypopnoea syndrome was 43.7% (1,559/3,564 patients). Diabetic neuropathy was more frequent in patients with sleep apnoea-hypopnoea syndrome in nine studies, although significantly only in four (60% vs 27%, p < .001; 64.5% vs 36%, p = .03; 37% vs 23.4%, p < .02; 66.6% vs 0%, p = .007). In one study, DN was more frequent in patients without SAHS (although not statistically significant) and in two no comparison was made between patients with/without sleep apnoea/hypopnoea syndrome. ConclusionsThe observed results suggest a relationship between diabetes mellitus and sleep apnoea-hypopnoea syndrome in the occurrence of diabetic neuropathy.