Rapid Improvement of Blood Glucose Level after Prosthetic Mandibular Advancement in a Patient with Diabetes Mellitus and Obstructive Sleep Apnea
Journal Title: Diabetes Research – Open Journal - Year 2015, Vol 1, Issue 3
Abstract
Introduction: Obstructive Sleep Apnea Syndrome (OSAS) is often associated with impaired glucose metabolism. However, the effects of Prosthetic Mandibular Advancement (PMA) on blood glucose levels and insulin resistance remain unclear. Therefore, we assessed the immediate effect of PMA on glycemic control measured using a Continuous Glucose Monitoring System (CGMS) in a patient with Type 2 Diabetes Mellitus (T2DM) and OSAS. Case presentation: A 77-year-old Japanese woman with T2DM was diagnosed with OSAS with a Respiratory Disturbance Index (RDI) of 39.3. Because the patient did not accept Continuous Positive Airway Pressure (CPAP) therapy, she wore a PMA that advanced the mandible 7 mm forward. Overnight sleep apnea monitoring and CGM were performed before and after wearing the PMA. PMA induced a marked reduction in RDI from 39.3 to 12.8, an increase in the minimum hemoglobin saturation from 78.0% to 87.0%, and a decrease in the number of episodes of oxygen desaturation of >4% below baseline in during the bedtime from 31.3 /h to 12.1 /h. The mean glucose level markedly improved with PMA from 126.1 to 100.5 mg/dL. Conclusion: The patient with showed improvement in RDI and glucose levels after wearing the PMA overnight. To our knowledge, this is the first case of a patient with OSAS and T2DM showing a beneficial effect of PMA on rapid glycemic control. CGMS may greatly help to promote compliance with the treatment of OSAS in patients with T2DM.
Authors and Affiliations
Naoko Aoyagi
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