NAVIGATING THE INTERCONNECTIONS OF OBSTRUCTIVE SLEEP APNEA AND DIABETES MELLITUS: A COMPREHENSIVE REVIEW OF PATHOPHYSIOLOGY AND MANAGEMENT STRATEGIES

The multifaceted bidirectional relationship between Obstructive Sleep Apnea (OSA) and Diabetes Mellitus (DM) represents a critical intersection in chronic disease management, with profound implications for patient outcomes. OSA is highly prevalent among individuals with Type 2 Diabetes Mellitus (T2D), and emerging evidence suggests its significance in Type 1 Diabetes Mellitus (T1D). The underlying pathophysiology involves complex interactions between intermittent hypoxia, systemic inflammation, and insulin resistance, contributing to the development and exacerbation of both conditions. Clinically, the coexistence of OSA and DM accelerates the progression of cardiovascular and microvascular complications, complicating management strategies and increasing patient morbidity and mortality. Early detection and management of OSA in diabetic patients are essential for improving glycemic control and reducing the risk of complications. Current guidelines advocate for routine OSA screening in diabetic patients, particularly those with poor glycemic control or obesity. Treatments like Continuous Positive Airway Pressure (CPAP) have shown promise in improving both sleep quality and metabolic outcomes. However, significant research gaps remain, particularly in understanding the prevalence of OSA in T1D, the molecular pathways linking these conditions, and the long-term benefits of OSA treatment on diabetic outcomes. Future research must focus on large-scale epidemiological studies, mechanistic insights, and personalized medicine approaches to optimize care for patients with coexisting OSA and DM. Addressing these gaps is crucial for advancing clinical practice and improving patient quality of life.