Obstructive Sleep Apnea and Ophthalmic Disorders-Clinical Implications.

Sleep is essential for physical, mental and emotional well being. Body systems require sleep of good quality and quantity for their proper functioning. There are several sleep disorders. Obstructive sleep apnea hypopnea syndrome (OSAHS) is one of the most important disorders identified in the last 50 years. The disorder has systemic ill effects by virtue of cyclical hypoxia and sympathetic stimulation. It is a risk factor for the development of hypertension, ischemic heart disease, type 2 diabetes mellitus, stroke and dementia. Retina being the highest oxygen consuming part of the body, is particularly vulnerable to the effects of hypoxia. Several eye disorders have been identified to be associated with OSAHS. In clinical practice Identifying and treating sleep disorders have been rewarding.

Sleep and type 2 diabetes mellitus- clinical implications.

Sleep is essential for life. Body systems require sleep of good quantity and quality for their proper functioning. Glucose metabolism can be affected adversely by several sleep disorders. Obstructive sleep apnea (OSA) is one of the most important disorder identified in the last 50 years which has systemic effects including glucose metabolism. Aging process also has its effects on glucose metabolism. There is a close relation between sleep, aging and metabolic syndrome. OSA and Type 2 Diabetes Mellitus (Type 2 DM) share several features in common. There is mounting evidence to show a close association between sleep deprivation, sleep disordered breathing-OSA, excessive sleepiness, insomnia, restless legs syndrome and Type 2 DM. The role of sleep deprivation, particularly REM sleep deprivation, in the genesis of obesity needs to be recognized. The close association of OSA with insulin resistance demands the recognition of OSA in fatty liver and polycystic ovary syndrome. Treatment of OSA by continuous positive airway pressure has been shown to increase insulin sensitivity. It is important for primary care physicians to have a high degree of suspicion of an underlying sleep disorder in patients with diabetes. Management of sleep disorder is highly rewarding.

Age- and sex-specific prevalence of diabetes and impaired glucose regulation in 11 Asian cohorts.

OBJECTIVE: To report the age- and sex-specific prevalence of diabetes and impaired glucose regulation (IGR) according to revised World Health Organization criteria for diabetes in Asian populations. RESEARCH DESIGN AND METHODS: We performed 11 studies of 4 countries, comprising 24,335 subjects (10,851 men and 13,484 women) aged 30-89 years who attended the 2-h oral glucose tolerance test and met the inclusion criteria for data analysis. RESULTS: The prevalence of diabetes increased with age and reached the peak at 70-89 years of age in Chinese and Japanese subjects but peaked at 60-69 years of age followed by a decline at the 70 years of age in Indian subjects. At 30-79 years of age, the 10-year age-specific prevalence of diabetes was higher in Indian than in Chinese and Japanese subjects. Indian subjects also had a higher prevalence of IGR in the younger age-groups (30-49 years) compared with that for Chinese and Japanese subjects. Impaired glucose tolerance was more prevalent than impaired fasting glycemia in all Asian populations studied for all age-groups. CONCLUSIONS: Indians had the highest prevalence of diabetes among Asian countries. The age at which the peak prevalence of diabetes was reached was approximately 10 years younger in Indian compared with Chinese and Japanese subjects. Diabetes and IGR will be underestimated in Asians based on the fasting glucose testing alone.