Effect of glycemic control on nocturnal arterial oxygen saturation: a case-control study in type 2 diabetic patients

J Diabetes. 2015 Jan;7(1):133-8. doi: 10.1111/1753-0407.12197. Epub 2014 Sep 10.


Background: There is growing evidence suggesting a deleterious effect of type 2 diabetes on lung function and sleep breathing. The aim of this case-control study was to evaluate whether or not an improvement in glycemic control could arrest or ameliorate nocturnal hypoxemia in type 2 diabetes.

Methods: Thirty patients with type 2 diabetes with HbA1c ≥8% (cases) and 10 non-diabetic subjects were analyzed. Controls were closely matched to cases by age, gender, body mass index, and neck circumference. The nocturnal oxygen desaturation index (ODI) was calculated at baseline and 5 days after blood glucose improvement with pharmacological intervention. Four different oxygen desaturation thresholds (reductions in SaO2 ≥ 3%, 4%, 6%, and 8%) as indicators of hypoxemia severity (ODI-3%, ODI-4%, ODI-6%, ODI-8%) were used.

Results: At baseline, patients with diabetes showed a higher number of ODI-3%, ODI-4%, and ODI-6% in comparison with controls. A significant reduction in ODI-3% (29.7 [4.8-107.9] events per hour at baseline versus 24.6 [3.1-97.7] e/h at discharge, P < 0.001), ODI-4% (21.7 [1.6-79.3] versus 14.7 [0.3- 79.4], P = 0.003), ODI-6% (9.3 [0.3-71.8] versus 4.0 [0.0-73.7], P = 0.001), and ODI-8% (4.1 [0.0-64.3] versus 1.1 [0.0-69.8], P = 0.033) was observed in patients with diabetes after 5 days of follow-up. However, no changes in ODI events were observed in non-diabetic patients after the same period. No significant changes in weight were observed in either group.

Conclusions: Glycemic control improvement significantly reduces the increased number of nocturnal oxygen desaturations that exist in type 2 diabetes. Although the mechanisms are not yet fully understood, the rapid effect without changes in body weight suggests a central mechanism involving respiratory center output.

Keywords: apnea; diabetic complications; hypoxia; lung; metabolic control; type 2 diabetes; 关键词:呼吸暂停,糖尿病并发症,缺氧,肺,代谢控制,2型糖尿病.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Glucose / metabolism*
  • Body Mass Index
  • Body Weight
  • Case-Control Studies
  • Diabetes Mellitus, Type 2 / metabolism*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Oxygen / metabolism*
  • Prognosis


  • Blood Glucose
  • Oxygen