TYPE 2 DIABETES and OBSTRUCTIVE SLEEP APNOEA: KEY FACTS
Diabetes is a chronic, potentially debilitating and often fatal disease. It occurs as a result of
problems with the production and supply of insulin in the body. Type 2 diabetes is a metabolic
disorder that results from a combination of the body’s inability to make effective use of the
insulin produced, and steadily worsening production of insulin to overcome that defect.
Obstructive sleep apnoea (OSA) is a common sleep disorder characterized by brief
interruptions of breathing during sleep. OSA is usually defined by interruptions in airflow of at
least 10 seconds or by a decrease in airflow of at least 10 seconds associated with either an
arousal (the brain briefly arouses people in order for them to resume breathing) or a blood
oxygen desaturation.
KEY FACTS

Diabetes affects over 250 million people worldwide and is expected to affect some 380 million
by 2025.1

Each year another 7 million people develop diabetes.1

In many countries in Asia, the Middle East, Oceania and the Caribbean, diabetes affects 1220% of the adult population.1

Seven out of the ten countries with the highest number of people living with diabetes are in
the developing world.1

In 2025, 80% of all diabetes cases will be in low– and middle-income countries.1

India has the largest diabetes population in the world with an estimated 41 million people,
amounting to 6% of the adult population.1

In China, where 4.3% of the population is affected by diabetes, the number of people with
this condition is expected to exceed 50 million within the next 20 years. 1

According to WHO, over 100 million people worldwide are affected by sleep apnoea.2

Further studies suggest that OSA affects about 4% of men and 2% of women in the general
population, however the prevalence rate is significantly higher in the obese population.3
LIFE-THREATENING COMPLICATIONS AND CONSEQUENCES

Each year, almost four million deaths are attributable to diabetes. An even greater number die
from cardiovascular disease made worse by diabetes-related lipid disorders and
hypertension.1

A person with type 2 diabetes is two to four times more likely to develop cardiovascular
disease (CVD), and 80% of people with diabetes will die from it.1

People with type 2 diabetes have a two to four times higher risk of coronary heart disease
than the rest of the population, and their prognosis is poorer. The risk of
cerebrovascular and peripheral vascular disease is also significantly
higher.1
Promoting diabetes care, prevention and a cure worldwide

Every 10 seconds a person dies from diabetes-related causes.1

People with mild to moderate OSA are twice as likely to develop hypertension as those without
OSA, people with severe OSA are almost three times as likely to develop hypertension as
those without OSA.4

OSA is associated with a range of CVD events such as stroke, heart failure and ischaemic
heart disease.5

People with sleep apnea have a 30% higher risk of heart attack or death than those
unaffected.6
ECONOMIC IMPACT

In 2007, the world was estimated to spend at least USD 232 billion to treat and prevent
diabetes and its complications. By 2025, this lower-bound estimate will exceed USD 302.5
billion.1

In the USA alone, the annual costs of diabetes amount to USD170 billion. 7 The lower-bound
estimated annual costs of diabetes in Japan, China and India are respectively ID
(International Dollars) 16 billion, 15 billion and 6 billion.1

The medical costs of untreated OSA in the United States are estimated at USD 3.4
billion/year, but the total economic impact of OSA is far greater if indirect costs such as loss of
productivity, work accidents, car and transport accidents and disability are taken into
account.8

According to a study by researchers at UCSD School of Medicine, each year in the USA
potentially 980 lives could be saved and USD11.1 billion in automobile-accident costs could be
avoided if drivers who suffer from obstructive sleep apnea were successfully treated. 9
OSA AND TYPE 2 DIABETES

Obstructive Sleep Apnoea (OSA) is the most common form of sleep-disordered breathing,
accounting for over 80% of cases.6

Estimates suggest that up to 40% of people with OSA will have diabetes, but the incidence of
new diabetes in people with OSA is not known.10

In people who have diabetes, the prevalence of OSA may be up to 23% 11, and the prevalence
of some form of sleep disordered breathing may be as high as 58%.12
References
1 Diabetes Atlas, third edition, International Diabetes Federation 2006.
2 World Health Organization, web page accessed 19/05/08
www.who.int/entity/gard/publications/chronic_respiratory_diseases.pdf,
3 Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S: The occurrence of sleep disordered breathing among middle
aged adults. NEJM 328:1230-1235, 1993
4 Peppard PE, Young T, Palta M, Skatrud J: Prospective study of the association between sleep-disordered breathing and
hypertension. NEJM 342(19): 1378-1384, 2000
Promoting diabetes care, prevention and a cure worldwide
5
Shahar E, Whitney CW, Redline S, Lee ET, Newman AB, Javier Nieto F, O'Connor GT, Boland LL, Schwartz JE, Samet
JM: Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study. Am J
Respir Crit Care Med 163(1): 19-25, 2001
6 Wikipedia, website accessed 19/05/2008 http://en.wikipedia.org/wiki/Sleep_apnea
7 American Diabetes Association, website accessed 16/05/2008 http://www.diabetes.org/diabetes-statistics/cost-of-diabetes-inus.jsp
8 Kapur V, Blough DK, Sandblom RE, Hert R, de Maine JB, Sullivan SD, Psaty BM: The medical cost of undiagnosed
sleep apnea. Sleep 22(6): 749-755, 1999
9
OSA online, website accessed 19/05/2008 http://www.osaonline.com/uscd_study.asp
Meslier N, Gagnadoux F, Giraud P, Person C, Ouksel H, Urban T, Racineux JL: Impaired glucose-insulin metabolism
in males with obstructive sleep apnea syndrome. Eur Respir J 22(1): 156-160, 2003
11 West SD, Nicoll DJ, Stradling JR: Prevalence of obstructive sleep apnea in men with type 2 diabetes. Thorax 61(11):
945-950, 2006
12 Resnick HE, Redline S, Shahar E, Gilpin A, Newman A, Walter R, Ewy GA, Howard BV, Punjabi NM: Diabetes and
sleep disturbances: findings from the Sleep Heart Health Study. Diabetes Care 26(3): 702-709, 2003
10
Promoting diabetes care, prevention and a cure worldwide