Despite proliferating literature, the exact relationship between obstructive sleep apnea (OSA) and alterations in glucose metabolism is still controversial. There is growing evidence to suggest that OSA imposes adverse effects on glucose metabolism, but the translation into clinical effect is not well delineated. Many potential mechanisms are being explored, mostly relating to peripheral tissue response to insulin and more recently regarding pancreatic beta cell function of insulin secretion. The effect of OSA on glucose metabolism is likely to be influenced by many personal characteristics. Age, degree of adiposity, lifestyle, comorbidities, and even the stage of glucose disorder itself may modify the relationship between OSA and glucose metabolism. In the biologic system of the human body, all these interact to culminate in clinically relevant outcomes.
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