Rapid Improvement of Blood Glucose Level after Prosthetic Mandibular Advancement in a Patient with Diabetes Mellitus and Obstructive Sleep Apnea
Obstructive sleep apnea syndrome is often associated with the metabolic syndrome and also
with hypertension, hyperlipidemia, ischemic heart disease, cerebrovascular disease,
and impaired glucose metabolism.
Because of the relationship between OSAS and type 2 diabetes mellitus, the effectiveness
of continuous positive airway pressure therapy in patients with T2DM has been assessed
in many trials, with Hemoblobin A1c levels improving in some patients.
However, the effects of prosthetic mandibular advancement on blood glucose
levels and insulin resistance remain unclear.
Continuous glucose monitoring system is a recently developed electronic system designed
to continuously monitor subcutaneous glucose concentration in the interstitial
fluid. CGMS is a powerful tool for T2DM control because it
provides a detailed daily blood glucose profile.
Here we assessed the immediate effect of PMA on glycemic control measured using
CGMS in a T2DM patient with OSAS. 77-year-old Japanese woman with T2DM was admitted
to Fukuoka University Hospital, Japan for attending a diabetes mellitus education program.
Her Fasting Blood Sugar and serum C-peptide levels were 152 mg/ dL and 2.22 ng/mL,
respectively, indicating a relatively maintained insulin secretory ability.
The patient was started on a diet of 1400 kcal/day during her hospital stay.
For 14 days, her FBS levels were well controlled; hence insulin therapy was discontinued
and only the 1400 kcal/day diet was maintained.
OSAS is characterized by repetitive episodes of upper airway obstruction occurring during sleep,
generally associated with a decrease in blood oxygen saturation. Furthermore, OSAS is associated
with insulin resistance and T2DM.
Diabetes Res Open J. 2015; 1(3): 67-71. doi: 10.17140/DROJ-1-110
