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RSSDI clinical practice recommendations for screening, diagnosis, and treatment in type 2 diabetes mellitus with obstructive sleep apnea

Abstract

Purpose of the study

Type 2 diabetes mellitus (T2DM) and obstructive sleep apnea (OSA) are closely associated diseases with a significant impact on public health. Both diseases are highly prevalent and the common overlapping risk factors include obesity, old age, and a generally high preponderance in men. A growing body of evidence suggests a bidirectional association between OSA and T2DM; both, in turn, constitute as strong risk factors for cardiovascular diseases, the leading cause of premature deaths and morbidity in India. Several studies have reported a higher prevalence of OSA in Indian patients with T2DM, despite lower levels of obesity. However, OSA remains an underdiagnosed condition in Indian patients with T2DM due to lack of awareness, uncertainty about treatment options, and non-availability of diagnostic facilities.

Methods

This document embodies evidence-based clinical practice recommendations and outlines an optimized care pathway for patients with T2DM and OSA, based on consensus multidisciplinary observations and clinical experiences.

Results and conclusions

Implementation of screening, diagnosis, and treatment of OSA in patients with T2DM at initial stages could potentially alleviate the risk of cardiovascular disease and substantially improve their quality of life. The recommendations emphasize the need for collaborative efforts from diabetologists, endocrinologists, and sleep medicine specialists towards systematic screening, diagnosis, and treatment of coexisting T2DM and OSA for enhanced patient care.

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Acknowledgments

The preparation of this article was supported by ResMed India Pvt. Ltd. Priya Ganpathy, MPharm CMPP, provided medical writing assistance and Sangita Patil, PhD CMPP (SIRO Clinpharm Pvt. Ltd), provided additional editorial support. Manasi Date, PhD (SIRO Clinpharm Pvt. Ltd), provided support with literature search and data extraction.

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Extended working group: Dr Anuj Maheshwari, Dr. B.M. Makkar, Dr Bikask Bhattacharjee, Dr C R Anand Moses, Dr C H Vasanth Kumar, Dr J K Sharma, Dr L Srinivas Murthy, Dr Pratap Jethwani, Dr Rajeev Chawla, Dr Ravindra Mehta, Dr Sanjay Reddy, Dr Shalini Jaggi, Dr Sudhir Bhandari, Dr Sujoy Ghosh, Dr Sunil Gupta, Dr Suresh Ramasubban, Dr Vijay Panikar

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Viswanathan, V., Ramakrishnan, N., Saboo, B. et al. RSSDI clinical practice recommendations for screening, diagnosis, and treatment in type 2 diabetes mellitus with obstructive sleep apnea. Int J Diabetes Dev Ctries 41, 4–21 (2021). https://doi.org/10.1007/s13410-020-00909-1

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Keywords

  • Consensus guideline
  • Continuous positive airway pressure
  • India
  • Obstructive sleep apnea
  • Type 2 diabetes mellitus