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06-10-2009 | Diabetes | Article

Weight loss improves OSA in obese patients with Type 2 diabetes

Abstract

Free abstract

MedWire News: Weight loss results in significant improvements in the symptoms of obstructive sleep apnea (OSA) in obese patients with Type 2 diabetes, report researchers from the Sleep AHEAD study.

Overweight or obese patients with Type 2 diabetes were recently found to have an extremely high rate of OSA of around 86%, say Gary Foster (Temple University, Philadelphia, USA) and colleagues.

In this study, the team investigated the impact of weight loss on OSA in 264 individuals with Type 2 diabetes taking part in the Sleep AHEAD (Action for Health in Diabetes) study. The participants were aged 61.2 years on average, had a mean body mass index (BMI) of 36.7 kg/m2, and an apnea-hypopnea index (AHI) of 26 events per hour.

The researchers randomly assigned the participants to a weight loss program designed specifically to help obese patients with Type 2 diabetes – intensive lifestyle intervention (ILI; n=125) – or three group sessions on effective diabetes management – diabetes support and education (DSE; n=139).

As reported in the Archives of Internal Medicine, the ILI was significantly more effective for achieving weight loss at 1 year than DSE, with an average reduction of 10.8 kg versus 0.6 kg.

Compared with the DSE group, ILI patients experienced a significantly greater decrease in AHI of 9.7 events per hour.

In addition, at 1 year, three times as many participants who received the ILI intervention had achieved complete remission of OSA as those in the DSE group, and half as many ILI than DSE group members had severe OSA.

Further analysis demonstrated that initial AHI and weight loss were the strongest predictors of improvement in AHI at 1 year.

Of note, AHI continued to worsen in those who did not lose weight over the course of the study, suggesting that “OSA is a rapidly progressing syndrome that will worsen without treatment in middle-aged obese adults with Type 2 diabetes,” say Foster et al.

They conclude: “Physicians and their patients can expect that weight loss will result in significant and clinically relevant improvements in OSA among obese patients with Type 2 diabetes.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2009

By Helen Albert