Abstract
Objective: To evaluate the effect of CPAP therapy on central (aortic) pressure and vascular stiffness in patients with type 2 diabetes mellitus (DM), suffering from moderate to severe obstructive sleep apnea (OSA). Design and method: The study involved 42 people with diabetes combined with hypertension 1–2 degrees and of moderate-to-severe OSA. 22 patients (group 1 CPAP) in addition to antihypertensive treatment (AHT) received a 12-week CPAP-therapy by device «Somnobalance e» (Weinmann, Germany). The 2nd (control - C) group consisted of 20 patients with diabetes who were on drug therapy without additional treatment by CPAP. The subjects were matched by age, sex, height, office blood pressure values. Assessment of respiratory disorders during sleep was carried out using cardiorespiratory monitoring SOMNOcheck2 (Weinmann, Germany). Biochemical parameters were determined by the Olympus AU 400 instrument (Olympus Corporation, Japan). In addition, the values of aortic pressure (SBPao, DBPao) during the night were evaluated by the technology Vasotens (Peter Telegin, Russia). Results: Capillary blood glucose levels in patients in group 1 were 8,8 ± 1,9 mmol/l, HbA1C - 8,1 ± 0,8%; in subjects in group 2 - 8,2 ± 1,6 mmol/l and 0,9 ± 7,9%, respectively (p > 0,05). Fasting glycemia in CPAP group after 12 weeks decreased by 12.5% (p < 0,01), HbA1C - 4% (p < 0,05); in patients of control group, respectively, 4,9% and 1,3% (p > 0,05). According to the daily monitoring in group 1 the initial values of SBPao and BPao were 124,5 (119,5; 135,5) and 78 ± 5,9 mmHg, in group 2 - 123,1 ± 9,7 mmHg, and 78,9 ± 9,2 mmHg (ND). Against the background of the 12-week treatment in CPAP group the values of SBPao decreased by 9,4%, (p < 0,01), DBPao - by 15,3% (p < 0,01). In the control group dynamic of SBPao was 5,1% (p < 0,05), DBPao - 7,3% (p < 0,01). Conclusions: The use of CPAP in patients with type 2 diabetes mellitus combined with hypertension and apnea contributes to a more pronounced decline in the central (aortic) pressure and the effective control of parameters of carbohydrate metabolism.
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