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Meta-analysis Evaluating the Effect of Sodium-Glucose Co-Transporter-2 Inhibitors on the Risk for New-Onset Obstructive Sleep Apnea in Patients With Type 2 Diabetes Mellitus Regardless of Cardiovascular Disease at Baseline

      Obstructive sleep apnea (OSA) is a relatively common, chronic sleep disorder closely related to type 2 diabetes mellitus (T2DM).
      • Reutrakul S
      • Mokhlesi B.
      Obstructive sleep apnea and diabetes: a state of the art review.
      OSA is also related to cardiovascular disease development, representing a modifiable cardiovascular risk factor.
      • Yeghiazarians Y
      • Jneid H
      • Tietjens JR
      • Redline S
      • Brown DL
      • El-Sherif N
      • Mehra R
      • Bozkurt B
      • Ndumele CE
      • Somers VK.
      Obstructive sleep apnea and cardiovascular disease: a scientific statement from the American Heart Association.
      It is an independent risk factor for coronary artery disease, cerebrovascular disease, and all-cause mortality.
      • Wang X
      • Ouyang Y
      • Wang Z
      • Zhao G
      • Liu L
      • Bi Y.
      Obstructive sleep apnea and risk of cardiovascular disease and all-cause mortality: a meta-analysis of prospective cohort studies.
      Therefore, its treatment, and preferably its primary prevention, seems to be of utmost importance. Sodium-glucose co-transporter-2 (SGLT-2) inhibitors, a novel class of antidiabetics, have revolutionized the treatment of patients with T2DM because they exert cardio-protective and reno-protective beneficial effects.
      • Wojeck BS
      • Inzucchi SE
      • Neeland IJ
      • Mancuso JP
      • Frederich R
      • Masiukiewicz U
      • Cater NB
      • McGuire DK
      • Cannon CP
      • Yaggi HK.
      Ertugliflozin and incident obstructive sleep apnea: an analysis from the VERTIS CV trial.
      Effects such as body weight reduction, osmotic diuresis leading to plasma volume contraction, and suppression of sympathetic nervous system activity may be mechanisms mediated by SGLT-2 inhibitors with potential useful implications for patients with OSA or at high risk for OSA development. However, there is no evidence concerning the role of SGLT-2 inhibitors in the prevention of OSA in patients with T2DM.
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