Glycemic trends following hypoglossal nerve stimulation in patients with obstructive sleep apnea and type 2 diabetes

To describe glycemic trends following hypoglossal nerve stimulation (HNS) therapy in patients with obstructive sleep apnea (OSA) and type 2 diabetes.

A retrospective review was conducted of patients with type 2 diabetes who underwent HNS therapy at an academic institution. The study population consisted of 17 diabetic patients who received HNS therapy between Jan 2020 to Oct 2024. Data collected included patient demographics, as well as baseline and post-operative apnea-hypopnea index (AHI) values obtained via polysomnography to assess OSA severity. Diabetes-related parameters included hemoglobin A1c (HbA1c), insulin use, and diabetes medication use. Statistical analyses were performed using IBM SPSS Statistics version 31.0.1.0 with P < 0.05 considered statistically significant.

The cohort was 52.9% male with a mean age of 65.3 ± 6.4 years, body mass index of 30.4 ± 3.6 kg/m2, and baseline AHI of 32.4 ± 14.4 events/h. Post-implantation, mean HbA1c decreased from 6.60 to 6.26 (mean change -0.31, p = 0.24). Of the 6 patients who were insulin-dependent prior to HNS implantation, 3 (50%) were able to discontinue insulin use during follow-up. Pearson correlation analysis demonstrated an association between AHI improvement and HbA1c improvement (r = -0.69, p = 0.027). Greater reductions in medication burden were significantly associated with improvements in both AHI and HbA1c.

In this retrospective cohort, HNS therapy was associated with trends toward lower HbA1c and reduced insulin dependence, although these findings did not reach statistical significance. These results underscore the need for further studies to better understand the role of HNS in improving glycemic control.