Obstructive sleep apnea (OSA) and diabetes has been known to be closely related to each other and both diseases impact highly on the public health. There are many evidence of reports that OSA is associated with diabetes with a bidirectional correlation. A possible causal mechanism of OSA to diabetes is intermittent hypoxemia and diabetes to OSA is microvascular complication. However, OSA and diabetes have a high prevalence rate in public and shares the common overlap characteristic and risk factors such as age, obesity, and metabolic syndrome that make it difficult to establish the exact pathophysiologic mechanism between them. In addition, studies demonstrating that treatment of OSA may help prevent diabetes or improve glycemic control have not shown convincing result but have become a great field of interest research. This review outlines the bidirectional correlation between OSA and diabetes and explore the pathophysiologic mechanisms by approaching their basic etiologies.

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• Obstructive Sleep Apnoea and Type 1 Diabetes Mellitus: A Neglected Relationship?
  Theodoros Panou, Konstantinos Roukas, Konstantina Chadia, Evangelia Nena, Evanthia Gouveri, Nikolaos Papanas, Paschalis Steiropoulos
  Experimental and Clinical Endocrinology & Diabetes.2025; 133(01): 40.     CrossRef
• Sex differences among sleep disordered breathing, obesity, and metabolic comorbidities; the Nagahama study
  Takeshi Matsumoto, Kimihiko Murase, Yasuharu Tabara, Takuma Minami, Osamu Kanai, Hironobu Sunadome, Naomi Takahashi, Satoshi Hamada, Kiminobu Tanizawa, Tomoko Wakamura, Naoko Komenami, Kazuya Setoh, Takahisa Kawaguchi, Satoshi Morita, Yoshimitsu Takahashi
  Respiratory Investigation.2025; 63(1): 42.     CrossRef
• Airway Collapsibility during Drug‐Induced Sleep Endoscopy Relates with Clinical Features of Obstructive Sleep Apnea
  Manan Parekh, Vasiliki Triantafillou, Brendan T. Keenan, Everett G. Seay, Eric Thuler, Alan R. Schwartz, Raj C. Dedhia
  The Laryngoscope.2024; 134(4): 1978.     CrossRef
• The effects of an exercise program on inflammation in adults who differ according to obstructive sleep apnea severity
  Devon A. Dobrosielski, Karla A. Kubitz, Mary F. Walter, Hyunjeong Park, Christopher Papandreou, Susheel P. Patil
  Sleep and Biological Rhythms.2024; 22(3): 303.     CrossRef
• Clinical features and predictors of metabolic syndrome among obstructive sleep apnea patients
  Safy Zahid Kaddah, Merna Hamada Korany, Eman Kamal Ibrahim
  The Egyptian Journal of Bronchology.2024;[Epub]     CrossRef
• Role of Sleep and Sleep Disorders in Cardiometabolic Risk: a Review and Update
  Shaden O. Qasrawi, Ahmed S. BaHammam
  Current Sleep Medicine Reports.2024; 10(1): 34.     CrossRef
• Evaluate the Relationship Between Obstructive Sleep Apnea and Metabolic Syndrome in Real-World Data
  Renzhe Tang, Chong Li, Dongmei Di, Lin Zhou, Yongxiang Qian, Chaohua Qiang, Chao Ma, Rui Zhou, Bin Wang, Min Wang
  Nature and Science of Sleep.2024; Volume 16: 217.     CrossRef
• Metabolic Crossroads: Unveiling the Complex Interactions between Obstructive Sleep Apnoea and Metabolic Syndrome
  Aisling Heffernan, Darko Duplancic, Marko Kumric, Tina Ticinovic Kurir, Josko Bozic
  International Journal of Molecular Sciences.2024; 25(6): 3243.     CrossRef
• The benefits of hypoglycemic therapy for patients with obstructive sleep apnea
  Ruihan Lin, Wenjie Yan, Meng He, Bin Liu, Xiaoli Su, Minhan Yi, Yuan Zhang
  Sleep and Breathing.2024; 28(3): 1355.     CrossRef
• Differences in Positive Airway Pressure Requirements in Obstructive Sleep Apnea Between Black and White Patients
  Yi Cai, Manan H. Parekh, Julianna Rodin, Akshay Tangutur, Jason L. Yu, Brendan T. Keenan, Alan R. Schwartz, Raj C. Dedhia
  Otolaryngology–Head and Neck Surgery.2024; 171(3): 910.     CrossRef
• A Machine Learning Prediction Model of Adult Obstructive Sleep Apnea Based on Systematically Evaluated Common Clinical Biochemical Indicators
  Jiewei Huang, Jiajing Zhuang, Huaxian Zheng, Ling Yao, Qingquan Chen, Jiaqi Wang, Chunmei Fan
  Nature and Science of Sleep.2024; Volume 16: 413.     CrossRef
• Analysis of the contribution of obstructive sleep apnea/hypopnea syndrome and glycemic level variability to the development and progression of cardiac arrhythmias in patients with type 2 diabetes mellitus
  A. V. Enert, D. G. Apalkov, S. R. Pereletova, K. V. Trubchenko, T. V. Saprina
  Diabetes mellitus.2024; 27(2): 158.     CrossRef
• Reoxygenation Mitigates Intermittent Hypoxia-Induced Systemic Inflammation and Gut Microbiota Dysbiosis in High-Fat Diet-Induced Obese Rats
  Menglu Dong, Xili Liang, Tian Zhu, Ting Xu, Liwei Xie, Yuan Feng
  Nature and Science of Sleep.2024; Volume 16: 517.     CrossRef
• Obstructive sleep apnea: Overlooked comorbidity in patients with diabetes
  Eric D Tenda, Joshua Henrina, Jin H Cha, Muhammad R Triono, Ersananda A Putri, Dahliana J Aristy, Dicky L Tahapary
  World Journal of Diabetes.2024; 15(7): 1448.     CrossRef
• The mediating effect of TyG and its derived indices in the association between OSAHS and atherosclerosis in patients with T2DM
  Ling Ding, Xiaohong Jiang
  Sleep and Breathing.2024; 28(6): 2469.     CrossRef
• Association and interaction effect of shift work and the risk for obstructive sleep apnea on diabetes mellitus in middle-aged Korean workers
  Kyusung Kim, Hi-Ju Kim, Seunghyun Lee, Wanhyung Lee
  Sleep and Breathing.2024; 28(6): 2721.     CrossRef
• Sleep Deficiency in Obstructive Sleep Apnea
  Olurotimi Adekolu, Muneeb Ahsan, Andira I. Anwar, Andrey Zinchuk
  Sleep Medicine Clinics.2024; 19(4): 687.     CrossRef
• A Prediction Nomogram of Severe Obstructive Sleep Apnea in Patients with Obesity Based on the Liver Stiffness and Abdominal Visceral Adipose Tissue Quantification
  Anbang Zhao, Bin Hao, Simin Liu, Xiaoyu Qiu, Xiaoping Ming, Xiuping Yang, Jie Cai, Zhen Li, Xiong Chen
  Nature and Science of Sleep.2024; Volume 16: 1515.     CrossRef
• Estimated prevalence of obstructive sleep apnea by occupation and industry in England: a descriptive study
  Ryohei Kinoshita, Jennifer K Quint, Constantinos Kallis, Michael I Polkey
  Sleep Advances.2024;[Epub]     CrossRef
• Dental pulp stem cells promote genioglossus repair and systemic amelioration in chronic intermittent hypoxia
  Meng-Han Zhang, Wei-Hua Zhang, Yun Lu, Li-Ming Yu, Xin-Xin Han, Yan Xu, Meng-Jie Wu, Wang-Hui Ding, Yue-Hua Liu
  iScience.2024; 27(11): 111143.     CrossRef
• An Artificial Intelligence-Based Non-Invasive Approach for Cardiovascular Disease Risk Stratification in Obstructive Sleep Apnea Patients: A Narrative Review
  Luca Saba, Mahesh Maindarkar, Narendra N. Khanna, Anudeep Puvvula, Gavino Faa, Esma Isenovic, Amer Johri, Mostafa M. Fouda, Ekta Tiwari, Manudeep K. Kalra, Jasjit S. Suri
  Reviews in Cardiovascular Medicine.2024;[Epub]     CrossRef
• Endocrine disorders in obstructive sleep apnoea syndrome: A bidirectional relationship
  Maud Akset, Kris Gustave Poppe, Pierre Kleynen, Ionela Bold, Marie Bruyneel
  Clinical Endocrinology.2023; 98(1): 3.     CrossRef
• Association between snoring and insulin levels in the US population: a cross-sectional study
  Kun Wang, Xuzhong Hu, Ziao Li, Michael Smolinski, Wenjie Xiao, Jinshen He
  Sleep and Breathing.2023; 27(3): 1185.     CrossRef
• Sleep disordered breathing and haemoglobin A1c levels within or over normal range and ageing or sex differences: the Nagahama study
  Takeshi Matsumoto, Kimihiko Murase, Yasuharu Tabara, Takuma Minami, Osamu Kanai, Hirofumi Takeyama, Hironobu Sunadome, Tadao Nagasaki, Naomi Takahashi, Yoshinari Nakatsuka, Satoshi Hamada, Tomohiro Handa, Kiminobu Tanizawa, Isuzu Nakamoto, Tomoko Wakamura
  Journal of Sleep Research.2023;[Epub]     CrossRef
• Acceptability, adaptability and adherence to CPAP therapy among Aboriginal Australians with OSA - “The A5 study”
  Subash S. Heraganahally, Timothy P. Howarth, Ara J. Perez, Jessie Crespo, Charmain B. Atos, Brian J. Cluney, Linda P. Ford
  Sleep Medicine.2023; 102: 147.     CrossRef
• Comorbid obstructive sleep apnea is associated with adverse cardiovascular outcomes in female patients with acute coronary syndrome complicating metabolic syndrome
  Bin Wang, Xiaogang Liu, Wen Hao, Jingyao Fan, Bin Que, Hui Ai, Xiao Wang, Shaoping Nie
  Clinical Cardiology.2023; 46(6): 663.     CrossRef
• Dyslipidemia prevalence in nonobese, nondiabetic patients with obstructive sleep apnea: does sex matter?
  Ozen K. Basoglu, Mehmet Sezai Tasbakan, Meral Kayikcioglu
  Journal of Clinical Sleep Medicine.2023; 19(5): 889.     CrossRef
• Plasma tRF-16-79MP9PD and tRF-28-OB1690PQR304 as potential biomarkers for 4- to 7-year-old children with obstructive sleep apnea-hypopnea syndrome
  Junhua Wu, Xiaohong Cai, Yanbo Lu, Yijing Shen, Zhisen Shen, Qin Lyv
  Frontiers in Pediatrics.2023;[Epub]     CrossRef
• Association of obstructive sleep apnea with cardiometabolic diseases and cardiovascular mortality
  Jia Gao, Licheng Shi, Xuanfeng Zhu, Jiannan Liu
  The Clinical Respiratory Journal.2023; 17(8): 764.     CrossRef
• Comparison of the Patients with Diabetes Mellitus using Either Insulin or Oral Antidiabetic Drug in Terms of Difficult Laryngoscopy: A Randomized Controlled Study
  M Win, K Erkalp, S Demirgan, FG Ozcan, MS Sevdi, A Selcan
  Nigerian Journal of Clinical Practice.2023; 26(10): 1423.     CrossRef
• Evaluation of the Continuous Positive Airway Pressure Effect on Neurotrophins’ Gene Expression and Protein Levels
  Agata Gabryelska, Szymon Turkiewicz, Marta Ditmer, Adrian Gajewski, Piotr Białasiewicz, Dominik Strzelecki, Maciej Chałubiński, Marcin Sochal
  International Journal of Molecular Sciences.2023; 24(23): 16599.     CrossRef
• Insulin Resistance, but Not Obstructive Sleep Apnea Is Associated with Hepatic Steatosis in Chinese Patients with Severe Obesity
  Chonggui Zhu, Shaofang Tang, Jinfeng Xiao, Yang Zhang, Longhao Sun, Jing Zhang, Li Ding, Ming Liu
  Obesity Facts.2023; 16(4): 344.     CrossRef
• Association of Metabolic Syndrome With Long-Term Cardiovascular Risks and All-Cause Mortality in Elderly Patients With Obstructive Sleep Apnea
  Lin Liu, Xiaofeng Su, Zhe Zhao, Jiming Han, Jianhua Li, Weihao Xu, Zijun He, Yinghui Gao, Kaibing Chen, Libo Zhao, Yan Gao, Huanhuan Wang, JingJing Guo, Junling Lin, Tianzhi Li, Xiangqun Fang
  Frontiers in Cardiovascular Medicine.2022;[Epub]     CrossRef
• Therapeutic effect of laparoscopic sleeve gastrectomy on obstructive sleep apnea and relationship of type 2 diabetes in Japanese patients with severe obesity
  Shingo Yanari, Akira Sasaki, Akira Umemura, Yasushi Ishigaki, Haruka Nikai, Tsuguo Nishijima, Shigeru Sakurai
  Journal of Diabetes Investigation.2022; 13(6): 1073.     CrossRef
• Advances in the study of OSA and diabetic foot
  Jiayu Lin, Hailing Song, Meihong Liang, Zeqiang Cai, Tan Chen, Zhenyu Lin, Jinying Zhang
  Diabetology & Metabolic Syndrome.2022;[Epub]     CrossRef
• VEGF Receptor 1 Promotes Hypoxia-Induced Hematopoietic Progenitor Proliferation and Differentiation
  Jonathan Florentin, Scott P. O’Neil, Lee L. Ohayon, Afaz Uddin, Sathish Babu Vasamsetti, Anagha Arunkumar, Samit Ghosh, Jennifer C. Boatz, Justin Sui, Corrine R. Kliment, Stephen Y. Chan, Partha Dutta
  Frontiers in Immunology.2022;[Epub]     CrossRef
• Sleep Deficiency in Obstructive Sleep Apnea
  Olurotimi Adekolu, Andrey Zinchuk
  Clinics in Chest Medicine.2022; 43(2): 353.     CrossRef
• Intermittent Hypoxia Interferes with Autocrine Effects of GABA on Insulin Secretion in Postnatal Rodents—Implications for Pediatric Obstructive Sleep Apnea
  Eung-Kwon Pae, Man-Kyo Chung, Ronald M. Harper
  Children.2022; 9(9): 1305.     CrossRef
• CPAP Influence on Readily Available Inflammatory Markers in OSA—A Pilot Study
  Ioana Madalina Zota, Cristina Andreea Adam, Dragoș Traian Marius Marcu, Cristian Stătescu, Radu Sascău, Larisa Anghel, Daniela Boișteanu, Mihai Roca, Corina Lucia Dima Cozma, Alexandra Maștaleru, Maria Magdalena Leon Constantin, Elena Andreea Moaleș, Flor
  International Journal of Molecular Sciences.2022; 23(20): 12431.     CrossRef
• Body weight and obstructive sleep apnea: a mathematical relationship between body mass index and apnea-hypopnea index in veterans
  Deema Fattal, Stacy Hester, Linder Wendt
  Journal of Clinical Sleep Medicine.2022; 18(12): 2723.     CrossRef
• Hypoxia signaling and cholesterol/steroidogenic acute regulatory protein 1 axis: interplay and role in alcohol and non-alcohol-related liver diseases
  Sandra Torres, Jose C. Fernandez-Checa, Carmen Garcia-Ruiz
  Exploration of Digestive Diseases.2022; : 170.     CrossRef
• Obstructive Sleep Apnea, Circadian Clock Disruption, and Metabolic Consequences
  Mikołaj Malicki, Filip Franciszek Karuga, Bartosz Szmyd, Marcin Sochal, Agata Gabryelska
  Metabolites.2022; 13(1): 60.     CrossRef
• The relationship between metabolic syndrome and obstructive sleep apnea syndrome: a nationwide population-based study
  Do Hyun Kim, Bongseong Kim, Kyungdo Han, Soo Whan Kim
  Scientific Reports.2021;[Epub]     CrossRef
• Triglyceride-Glucose Index in Non-Diabetic, Non-Obese Patients with Obstructive Sleep Apnoea
  Andras Bikov, Stefan M. Frent, Martina Meszaros, Laszlo Kunos, Alexander G. Mathioudakis, Alina Gabriela Negru, Laura Gaita, Stefan Mihaicuta
  Journal of Clinical Medicine.2021; 10(9): 1932.     CrossRef
• Evidence of an Association of Obstructive Sleep Apnea with Diabetes and Diabetic Complications
  Takeshi Matsumoto, Toyohiro Hirai, Kazuo Chin
  Current Sleep Medicine Reports.2021; 7(4): 186.     CrossRef
• Relationship between obstructive sleep apnea syndrome and functional capacity in patients with diabetes mellitus type 2: an observational transversal study
  Moyrane Abreu da Fonseca, Alana Karina Silva Moreira, Railsa Bertilla dos Santos Lima, Marcela de Araújo Oliveira, Aldair Darlan Santos-de-Araújo, Adriana Sousa Rêgo, Ludmilia Rodrigues Lima Neuenschwander Penha, Patrícia Rodrigues Ferreira, Maria Cláudia
  Revista da Associação Médica Brasileira.2021; 67(6): 878.     CrossRef
• Effects of Intermittent Hypoxia on Cytokine Expression Involved in Insulin Resistance
  Tomoko Uchiyama, Hiroyo Ota, Chiho Ohbayashi, Shin Takasawa
  International Journal of Molecular Sciences.2021; 22(23): 12898.     CrossRef
• Novel screening model of obstructive sleep apnea for snorers with suspected NAFLD undergoing liver sonography
  Yang-Bor Lu, Yu-Chieh Weng, Yung-Ning Huang, Hsiung-Ying Huang, Pei-Ting Cheng, Hui-Shan Hsieh, Ming-Shao Tsai
  BMC Pulmonary Medicine.2021;[Epub]     CrossRef
• Short sleep duration and food intake: an overview and analysis of the influence of the homeostatic and hedonic system
  Natálie Brito Gissoni, Marcus Vinicius Lucio dos Santos Quaresma
  Nutrire.2020;[Epub]     CrossRef
• Perioperative implications and prevalence of Obstructive Sleep Apnea risk in a surgical population using the updated STOP-Bang questionnaire
  Amr Elkouny, Mohamed AlHarbi, Vassilios Dimitriou, Ali Muzafar, Ali Nawaz, Amel Fayed
  Trends in Anaesthesia and Critical Care.2020; 30: 1.     CrossRef

• Obstructive Sleep Apnea Exacerbates Glucose Dysmetabolism and Pancreatic β-Cell Dysfunction in Overweight and Obese Nondiabetic Young Adults

  
  Ning Li, Yun Fan, Jian Ping Zhou, Ocholi Don Maimba, Liu Zhang, Qing Yun Li
  Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2020; Volume 13: 2465.     CrossRef
• Sleep disturbances: one of the culprits of obesity-related cardiovascular risk?
  Giovanna Muscogiuri, Dario Tuccinardi, Vincenzo Nicastro, Luigi Barrea, Annamaria Colao, Silvia Savastano
  International Journal of Obesity Supplements.2020; 10(1): 62.     CrossRef
• Mild maternal sleep-disordered breathing during pregnancy and offspring growth and adiposity in the first 3 years of life
  Avivit Brener, Yael Lebenthal, Sigal Levy, Galit Levi Dunietz, Orna Sever, Riva Tauman
  Scientific Reports.2020;[Epub]     CrossRef
• Association of parameters of nocturnal hypoxemia with diabetic microvascular complications: A cross-sectional study
  Pei Xue, Naima Covassin, Xingwu Ran, Junying Zhou, Xiaohan Zhang, Donge Yan, Xiao Li, Yun Gao, Xiangdong Tang
  Diabetes Research and Clinical Practice.2020; 170: 108484.     CrossRef
• Dynamic changes in nocturnal blood glucose levels are associated with sleep-related features in patients with obstructive sleep apnea
  Jung-Ick Byun, Kwang Su Cha, Ji Eun Jun, Tae-Joon Kim, Ki-Young Jung, In-Kyung Jeong, Won Chul Shin
  Scientific Reports.2020;[Epub]     CrossRef
• Conduite à tenir face à un patient candidat à la chirurgie bariatrique
  I. Fontanille, N. de’Angelis, C. Rives-Lange, S. Czernichow, P. Bouchard
  EMC - Odontologie.2020; 36(3): 1.     CrossRef
• Obstructive Sleep Apnea and Pain
  Konstantina Nikolaou, Athanasios Voulgaris, Paschalis Steiropoulos
  Current Sleep Medicine Reports.2019; 5(3): 95.     CrossRef
• Conduite à tenir face à un patient candidat à la chirurgie bariatrique
  I. Fontanille, N. de’Angelis, C. Rives-Lange, S. Czernichow, P. Bouchard
  EMC - Médecine buccale.2019; 12(6): 1.     CrossRef