ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title |
Inconclusive Evidence for Measuring the Impact of CPAP Treatment on Glucose Markers for Patients with Obstructive Sleep Apnea and Diabetes |
Clinical Question |
Do glucose markers for diabetic patients improve after receiving CPAP treatment? |
Clinical Bottom Line |
The evidence is inconclusive in demonstrating that CPAP treatment independently and directly impacts glucose marker for diabetic patients. |
Best Evidence |
(you may view more info by clicking on the PubMed ID link) |
PubMed ID |
Author / Year |
Patient Group |
Study type
(level of evidence) |
#1) 21863134 | Hect/2011 | 292 adults with diabetes and OSA | Systematic Review and Meta Analysis | Key results | Current studies are inconclusive more long term RCT and Cohort studies with sufficient power analysis are needed to validate CPAP therapy as a tool that can independently impact glucose markers in diabetic patients. | #2) 22411171 | Yang/2011 | non-diabetics using CPAP | Meta Analysis | Key results | For non-diabetic patients with moderate to severe OSA, CPAP therapy improved insulin resistance. However, it did not improve glycemic control for diabetics or non-diabetics. | #3) 22547887 | Weinstock/2012 | 50 subjects with moderate to severe sleep apnea (AHI > 15) and impaired glucose tolerance | Controlled Clinical Trial | Key results | CPAP therapy did not improve glucose tolerance for those with moderate sleep apnea and obesity. However, improved insulin sensitivity was observed for patients with severe sleep apnea (AHI>30).
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Evidence Search |
Continuous Positive Airway Pressure, CPAP
Diabetes Mellitus
Glucose/metabolism
Metabolic Syndrome
Insulin Resistance
Obstructive Sleep Apnea Therapy
Glycemic Control |
Comments on
The Evidence |
The systematic review and meta-analyses in the literature were unable to consistently and reliably document independent metrics for isolating the association between CPAP therapy and improved glucose markers in diabetic patients. |
Applicability |
Treatment is feasiable and applicable to private practitioners in general dentistry, proshthodonitcs and oral medicine. |
Specialty/Discipline |
(Oral Medicine/Pathology/Radiology) (General Dentistry) (Orthodontics) (Prosthodontics) (Dental Hygiene) |
Keywords |
CPAP
diabetic moderate to severe OSA
CPAP impaired glucose tolerance
Diabetes Mellitus
Obstructive Sleep Apnea Therapy
Glucose Metabolism
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ID# |
2390 |
Date of submission: |
03/12/2013 |
E-mail |
nguyenc@uthscsa.edu |
Author |
Carol A. Nguyen, RDH, MS |
Co-author(s) |
Alexander Ling |
Co-author(s) e-mail |
LingA@livemail.uthscsa.edu |
Faculty mentor/Co-author |
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Faculty mentor/Co-author e-mail |
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Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) |
post a rationale |
None available | |
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Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
by Michael Montgomery (San Antonio, Texas) on 05/13/2013 2012 studies by Prasad (PMID
23066358 ; retrospective cohort study) and Myhill (PMID
22962427 ; prospective cohort study) reported no improvement in glycemic control measures (fasting glucose and hemoglobinA1C values) in patients with Type II Diabetes Mellitus. Follow-up periods were one year for the Prasad study and 3 months in the Myhill study. Though the strength of these studies was inferior to those cited in the original CAT, these studies support the conclusion that evidence is lacking to support a therapeutic relationship between CPAP and Diabetic glycemia. | |
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