Sleep disordered breathing, such as that associated with obstructive sleep apnoea, has long been regarded by medical experts as creating a very high risk of diabetes Type 2. It affects people of all ages but almost doubles the risk for older patients.
People with both sleep apnoea and type 2 diabetes are now known to have more than double the risk of worsening retina disease compared to diabetics without the sleep breathing disorder, a UK study suggests.
Researchers followed adults with type 2 diabetes over about four years and found that for those with milder eye disease at the start, having sleep apnoea was linked to higher odds that it would become more advanced.
This new research led by the University of Birmingham has discovered that patients who suffer from both Type 2 diabetes and obstructive sleep apnoea are at greater risk of developing a condition that leads to blindness within an average period of less than four years.
The worse the sleep apnoea, the faster the progression of diabetic retinopathy, researchers found.
Previous studies have shown a link between OSA and diabetes-related eye problems. However, prior to this research led by the University of Birmingham, published in American Journal of Respiratory and Critical Care Medicine, there had been no published studies assessing the impact of OSA on the progression of diabetic retinopathy in patients with Type 2 diabetes.
The University of Birmingham’s Institute of Metabolism and Systems Research, states: “Despite improvements in glucose, blood pressure and lipid levels, diabetic retinopathy remains very common.
“Meanwhile, OSA has been shown to be very common in patients with Type 2 diabetes, which is not surprising considering that excess weight contributes to the development of both of these conditions. However, most patients who have OSA are not aware that they have the condition and the disease could go dangerously undiagnosed for years.
“However, more importantly, we have shown that patients with OSA and Type 2 diabetes, compared to those with diabetes only, are at increased risk of developing advanced diabetic retinopathy over a period of three years and seven months.”
The study was carried out at two diabetes clinics at hospitals in the Midlands and involved 230 patients with Type 2 diabetes. It excluded any patients who were already known to have OSA or any kind of respiratory condition.
The results showed that diabetic retinopathy prevalence was higher in patients with OSA (42.9%) compared to those without OSA (24.1%).
The study found that at a follow-up appointment, over 3 years later, the patients with OSA (18.4%) were much more likely to develop moderate to severe diabetic retinopathy compared to those without OSA (6.1%).
The study also showed that patients who received treatment for OSA had a lower risk of developing advanced diabetic retinopathy compared to patients who did not receive the treatment.
The findings of the study are very important because they can help to explore new treatments for the diabetic retinopathy. After the outcome of the research, clinicians now can take proper preventive measures while treating the patients with OSA and Type 2 diabetes. No doubt testing for OSA is essential because it is very common in Type 2 diabetes patients.
John Redfern
Source:
- ‘Obstructive Sleep Apnoea And Retinopathy in Patients With Type 2 Diabetes: A Longitudinal Study’. American Journal of Respiratory and Critical Care Medicine.
- To read the research paper visit http://www.atsjournals.org/doi/10.1164/rccm.201701-0175OC)
- This study was funded by The National Institute for Health Research UK,
