The recent epidemiological studies have shown that the obstructive sleep apnea (OSA) and type 2 diabetes mellitus are independently associated. There exist real and potential links between the risk factors for and comorbidities associated with diabetes and sleep apnea. There is a common occurrence of obesity, hypertension and disorders of metabolism in the two disorders. While the occurrence of sleep apnea with glucose intolerance or insulin resistance could present sampling bias, an alternative hypothesis is that the events in OSA trigger different, perhaps unique, adaptations in metabolic processes involving insulin action and glucose regulation. Impaired glucose tolerance and worsening insulin resistance can lead to further weight gain, exacerbating the severity of disordered breathing during sleep. This review aimed to define the extent and potential mechanisms for alterations in insulin and glucose levels in OSA.
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