Display options
Cite
Ioja S, Chasens ER, Ng J, et al. Obstructive sleep apnea in adults with type 1 and type 2 diabetes: perspectives from a quality improvement initiative in a university-based diabetes center. BMJ Open Diabetes Res Care. 2017;5(1):e000433doi: 10.1136/bmjdrc-2017-000433.
Ioja, S., Chasens, E. R., Ng, J., Strollo, P. J., & Korytkowski, M. T. (2017). Obstructive sleep apnea in adults with type 1 and type 2 diabetes: perspectives from a quality improvement initiative in a university-based diabetes center. BMJ open diabetes research & care, 5(1), e000433. https://doi.org/10.1136/bmjdrc-2017-000433
Ioja, Simona, et al. "Obstructive sleep apnea in adults with type 1 and type 2 diabetes: perspectives from a quality improvement initiative in a university-based diabetes center." BMJ open diabetes research & care vol. 5,1 (2017): e000433. doi: https://doi.org/10.1136/bmjdrc-2017-000433
Ioja S, Chasens ER, Ng J, Strollo PJ, Korytkowski MT. Obstructive sleep apnea in adults with type 1 and type 2 diabetes: perspectives from a quality improvement initiative in a university-based diabetes center. BMJ Open Diabetes Res Care. 2017 Aug 09;5(1):e000433. doi: 10.1136/bmjdrc-2017-000433. eCollection 2017. PMID: 28878943; PMCID: PMC5574455.
Copy Download .nbib Format: NLM
Share it on

BMJ Open Diabetes Res Care. 2017 Aug 09;5(1):e000433. doi: 10.1136/bmjdrc-2017-000433. eCollection 2017.

Obstructive sleep apnea in adults with type 1 and type 2 diabetes: perspectives from a quality improvement initiative in a university-based diabetes center.

BMJ open diabetes research & care

Simona Ioja, Eileen R Chasens, Jason Ng, Patrick J Strollo, Mary T Korytkowski

Affiliations

  1. Ohio Valley Medical Center, Wheeling, West Virginia, USA.
  2. Department of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
  3. Department of Medicine, Division of Endocrinology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
  4. Division of Allergy, Pulmonary and Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
  5. Department of Medicine, Division of Endocrinology and Metabolism, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

PMID: 28878943 PMCID: PMC5574455 DOI: 10.1136/bmjdrc-2017-000433

Abstract

OBJECTIVE: Obstructive sleep apnea (OSA) and diabetes are frequent comorbid conditions. Screening for OSA in patients with diabetes is recommended but the frequency with which this is done in clinical practice is unknown. The objectives of this quality improvement initiative were to identify clinician and patient perceptions regarding OSA and to identify the prevalence of patients at high risk for OSA (HROSA).

METHODS: A quality improvement initiative was conducted to query clinicians and patients attending a specialty diabetes clinic regarding attitudes and beliefs related to OSA. The Berlin Questionnaire was embedded in patient questionnaires to identify patients as low risk for OSA (LROSA) or HROSA.

RESULTS: 35 clinicians completed questionnaires with >80% agreement that OSA contributed to blood pressure (BP), glycemic control, and diabetes complications and that screening is a shared responsibility with other physicians; but only 17% indicated regular screening due predominantly to insufficient time. Of 107 patients (26 type 1 diabetes mellitus (T1DM) and 81 type 2 diabetes mellitus (T2DM)), 30% were aware that OSA could affect diabetes outcomes. The prevalence of known OSA, LROSA, and HROSA was similar in T1DM (15%, 50%, 35%) and T2DM (36%, 33%, 31%, respectively) (p=0.21). 59% of all HROSA patients indicated that OSA screening had never been discussed with them.

CONCLUSIONS: These results demonstrate that providers, but not patients, are knowledgeable about the importance of OSA screening, but insufficient time is a major barrier to wider screening. Approximately, 30% of patients with T1DM and T2DM were identified as HROSA supporting the need for procedures that improve detection and treatment.

Keywords: clinical practice pattern; diabetes mellitus; health beliefs; obstructive sleep apnea; quality improvement

Conflict of interest statement

Competing interests: MTK has served on an advisory board for Novo Nordisk. PJS discloses the following research grant support: RO1 HL107370, RO1 DK096028302, RO1 HL120354301A1, 1UH2HL125103301, 5UL1TR

References

  1. Patient Educ Couns. 2016 Aug;99(8):1427-31 - PubMed
  2. J Clin Endocrinol Metab. 2012 Nov;97(11):4212-8 - PubMed
  3. Diabetes Care. 2017 Jan;40(Suppl 1):S25-S32 - PubMed
  4. Diabetes Educ. 2013 Jan-Feb;39(1):74-82 - PubMed
  5. Am J Cardiol. 2017 Apr 1;119(7):996-1002 - PubMed
  6. J Clin Sleep Med. 2011 Feb 15;7(1):41-8 - PubMed
  7. Am J Respir Crit Care Med. 2010 Mar 1;181(5):507-13 - PubMed
  8. Am J Respir Crit Care Med. 2016 Aug 15;194(4):486-92 - PubMed
  9. Thorax. 2007 Nov;62(11):969-74 - PubMed
  10. Am J Respir Crit Care Med. 2016 Aug 15;194(4):516-9 - PubMed
  11. Qual Health Res. 2010 Jul;20(7):873-92 - PubMed
  12. Diabet Med. 2010 Apr;27(4):398-404 - PubMed
  13. Diabetes Care. 2016 Jan;39 Suppl 1:S60-71 - PubMed
  14. J Clin Sleep Med. 2012 Oct 15;8(5):587-96 - PubMed
  15. J Clin Sleep Med. 2009 Jun 15;5(3):263-76 - PubMed
  16. Diabetes Obes Metab. 2017 Mar;19(3):452-456 - PubMed
  17. Clin Respir J. 2011 Jul;5(3):165-72 - PubMed
  18. Arch Intern Med. 2009 Sep 28;169(17 ):1619-26 - PubMed
  19. Ann Intern Med. 1999 Oct 5;131(7):485-91 - PubMed
  20. Sleep. 2008 Nov;31(11):1551-8 - PubMed
  21. Sleep Med. 2009 Aug;10(7):753-8 - PubMed
  22. J Am Med Inform Assoc. 2005 Jul-Aug;12(4):431-7 - PubMed
  23. Sleep Breath. 2017 Mar;21(1):145-147 - PubMed
  24. Chest. 2012 Jun;141(6):1414-1421 - PubMed
  25. PLoS Med. 2014 Feb 04;11(2):e1001599 - PubMed
  26. Diabetes Care. 2009 Jun;32(6):1017-9 - PubMed
  27. Diabetes Res Clin Pract. 2008 Jul;81(1):2-12 - PubMed
  28. Diabet Med. 2015 Jan;32(1):90-6 - PubMed
  29. Proc Am Thorac Soc. 2008 Feb 15;5(2):173-8 - PubMed
  30. Proc Am Thorac Soc. 2008 Feb 15;5(2):185-92 - PubMed
  31. Endocrinol Metab Clin North Am. 2003 Dec;32(4):805-22, viii - PubMed
  32. Endocr Pract. 2015 Apr;21 Suppl 1:1-87 - PubMed

Publication Types

Grant support