Sleep Apnea May Be Linked to Nerve Damage in Diabetics

HealthDay – 4 hrs ago MONDAY, June 18 (HealthDay News) -- Obstructive sleep apnea is associated with nerve damage in people with type 2 diabetes, according to a new study.

The severity of this type of nerve damage -- called diabetic peripheral neuropathy -- is linked with the extent of sleep apnea and the degree of low blood oxygen levels that occur while patients sleep, the researchers found.

People with obstructive sleep apnea subconsciously awaken many times a night -- even dozens of times an hour -- because their airways close, disrupting their breathing. Those with diabetic peripheral neuropathy may have numbness or tingling in their extremities, or damage to their major organs.

The study of 234 adults with type 2 diabetes found that sleep apnea was independently associated with diabetic peripheral neuropathy even after the researchers accounted for a number of other possible factors, including obesity, ethnicity, gender, age at diabetes diagnosis, and the length of time a person had diabetes.

The findings were published online ahead of print in the American Journal of Respiratory and Critical Care Medicine.

"Obstructive sleep apnea is known to be associated with inflammation and oxidative stress, so we hypothesized that it would be associated with peripheral neuropathy in patients with type 2 diabetes," lead author Dr. Abd Tahrani, a clinical lecturer in endocrinology and diabetes at the University of Birmingham in England, said in a news release from the American Thoracic Society.

However, while the study uncovered an association between obstructive sleep apnea and peripheral neuropathy in diabetic patients, it did not prove a cause-and-effect relationship.

Further research is needed to determine the role of sleep apnea and low blood oxygen levels in the development and progression of nerve damage in patients with type 2 diabetes, and to assess the potential impact of continuous positive airway pressure treatment on diabetic peripheral neuropathy, the study authors said.

Continuous positive airway pressure treatment, or CPAP, keeps obstructive sleep apnea patients' airways open while they sleep.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about diabetic neuropathy.

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Personalized Blood Pressure Therapy May Help Diabetics

HealthDay – 4 hrs ago WEDNESDAY, May 30 (HealthDay News) -- Aggressive efforts to control blood pressure in people with diabetes may be leading to overtreatment with blood pressure drugs in some patients, a new study suggests.

Researchers examined data from nearly 1 million diabetes patients treated at Veterans Affairs health facilities across the United States and found that as many as 82 percent were receiving treatment to keep their blood pressure under control.

However, more than 8 percent of patients were possibly being overtreated to control their blood pressure, and 6 percent were not being treated as aggressively as they could be, the study found.

The findings, published online May 28 in the journal Archives of Internal Medicine, suggest that the current one-size-fits-all method of blood pressure control needs to be reconsidered, the researchers said.

This personalized approach should be possible with the help of electronic health records, which can combine blood pressure, prescription and other health data on patients' individual risks such as heart disease or balance problems, the study authors explained in a University of Michigan Health System news release.

"Appropriately treating blood pressure in people with diabetes is extremely important, and good blood pressure control should still be the goal to reduce risk of heart attack, stroke and other conditions," first author Dr. Eve Kerr, director of the Center for Clinical Management Research at the VA Ann Arbor Healthcare System and a professor of internal medicine at the University of Michigan Medical School, said in the news release.

"But just treating to a blood pressure target in all patients may result in overtreating and harming some patients because their blood pressures actually fall too low," she added. "We need to find better ways to measure and incentivize appropriate blood pressure management to make sure that patients who need aggressive treatment are getting it, and to decrease the rate of inappropriate overtreatment."

More information

The American Diabetes Association has more about high blood pressure and diabetes.

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China diabetics raise stakes for healthcare reform

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