Type 2 Diabetes With Sleep Apnea Linked To Retinopathy Progression

People with type 2 diabetes and obstructive sleep apnea (OSA) have a heightened risk of developing vision impairment in fewer than four years, according to new research.

Earlier studies indicated an association between OSA and diabetic retinopathy, but a recent study led by the University of Birmingham is the first to assess the influence of OSA on the progression of retinopathy in those with type 2 diabetes.

OSA occurs when the throat relaxes and narrows during sleep and blocks the passage of air, causing snoring or pauses in breathing. Diabetic retinopathy is a diabetes complication that can result in vision loss, and may lead to blindness.

Though OSA often co-occurs with type 2 diabetes many with OSA are unaware of it; the condition can go undiagnosed for years.

“Our study is the first to prospectively examine the impact of OSA on diabetic retinopathy,” said researcher Dr. Abd Tahrani. “Firstly, we showed that sight-threatening diabetic retinopathy was more common in patients with both type 2 diabetes and OSA compared to those with type 2 diabetes but without OSA.”

“However, more importantly, we have shown that patients with OSA and type 2 diabetes, compared to those with diabetes only, are at increased risk of developing advanced diabetic retinopathy over a period of three years and seven months.”

The research involved 230 individuals with type 2 diabetes. It excluded people earlier diagnosed with OSA, or other respiratory conditions. Each participant was then assessed for diabetic retinopathy and OSA. Analysis of the data showed 42.9 percent of participants with OSA had signs of diabetic retinopathy, compared to 24.1 percent of non-OSA participants.

At a follow-up appointment, on average 43 months later, those with OSA were more likely to have developed moderate to severe retinopathy symptoms (18.4 percent) than those without OSA (6.1 percent). This indicates that OSA is an independent predictor for a progression to moderate or severe retinopathy in type 2 diabetes patients.

“Following our research, it is important that clinicians treating patients with type 2 diabetes are aware that their patients who also have OSA are particularly at increased risk of developing advance retinopathy and, hence, appropriate preventative measures should be put in place," says Dr. Tahrani.

Source: University of Birmingham
Photo credit: Nithi Anand

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