Abstract

Background: Obstructive Sleep Apnea Syndrome (OSA) is a disabling condition displaying strongly associated with cardiovascular complications in Type 2 diabetes (T2DM). Therefore, OSA treatment is a compelling, yet not consistently successful task requiring lifestyle adaptations, bariatric surgery and mechanical device utilization, yet new anti-hyperglycemic drugs, i.e., sodium-glucose co-transporter 2 inhibitors (SGLT2-is) and Glucagon-like peptide-1 receptor agonists (GLP1-ras) could also help. We aimed to assess OSA prevalence and association with metabolic control and complications in T2DM patients on different treatment schedules. Methods: this retrospective study involved 3870 T2DM adults consecutively referring to our outpatient wards, polysomnographycally tested for apnea/hypopnea index (AHI) evaluation and divided into controls and mild (AHI 6-30 events/ hour) or severe OSA (≥30 events/hour) groups. Results: besides confirming the reported high OSA rate and close association with BMI, poor glucose control and cardiovascular complications, we also described increasing OSA severity with the rate and severity of T2DM metabolic derangement and comorbidities. Conclusion: T2DM patients must be tested and eventually treated for OSA to attain better metabolic outcomes and reduce/ prevent long-term complications. Whether SGLT2-is and GLP1-ras may prove successful per se or as an add-on to current treatment tools requires further investigation, possibly through dedicated clinical trials.