CPAP Induced Aerophagia Causes Elevated Blood Glucose Levels

[roster]

I think the regular members know that the ole Rooster often makes provocative statements. But let me seriously propose the subject statement as a new hypothesis of mine. First, a little story.

Early this week I listened to a bariatric surgeon (weight-loss surgeon, http://en.wikipedia.org/wiki/Bariatric_surgery ) give a talk about his practice. I heard two things that absolutely amazed me. This surgeon does adjustable gastric bands, sleeves and one other kind where you are left with a small pouch of a stomach (I forget what he called it).

Of course the objective is for obese people to lose considerable weight and he reports good success with this. A secondary objective is to cure some of the comorbidities common in obese patients. He talked about patients with hypertension and/or type 2 diabetes and reports that the surgery is curing both of these conditions.

Now here is the amazing part! The surgeon claims that after the surgery the patients do not have to wait for the weight loss to cure hypertension and type 2 diabetes. Both blood pressure and blood glucose levels are normal the night the patients go home from the surgery. He says it is not known why the sudden cure, but they suspect it has something to do with an immediate change in hormone secretion.

So I am thinking this week, use mechanical means (bariatric surgery including bands/sleeves) to reduce the size of the stomach and the hormone signaling process calls for a favorable change affecting blood glucose levels (and blood pressure levels).

Now back to aerophagia and blood glucose levels. I started CPAP three years ago with normal blood glucose levels. I have had three years of aerophagia caused by CPAP. During these three years my blood glucose levels steadily rose to the prediabectic level and they are still rising and are now near the diabetic level.

So that is a correlation in my case. And now here is why I hypothesize it is causative. If reducing the size of the stomach causes favorable changes in blood glucose levels, then maybe increasing the size of the stomach (by pumping it up with a CPAP machine) affects signaling that causes unfavorable changes (increases) in blood glucose levels.

Addendum: Here is another point I forgot about that is in favor of my working hypothesis. All of my morning fasting BG levels are high prediabetic or low diabetic. My postprandial readings are often high normal, occassionally prediabetic and rarely low diabetic. So the first morning readings are the real problem ones and later in the day the readings are closer to normal. I maintain that this supports the argument that the bloating of the stomach by CPAP pressure is contributing to higher BG levels.

[Linus]

Interesting theory. I am not sure I agree 100%, but I respect the idea. I am about 75% convinced.
It is a good motivation to keep the core muscles well toned. The one thing I fear most is what you talk about...raised glucose levels. In the last 30 years I have seen an alarming increase of people with diabetes.

I certainly think your theory would likely be a very good research topic someday, and I hope that if it does that the correlation can be proven to be a cause. Given that, many people' lives can be changed.

[Wulfman]

I haven't had any aerophagia to deal with, but did see my glucose levels rise from the "pre-D" levels in 2005 to "scary" in 2007, even though I had read that CPAP therapy was supposed to help normalize glucose.
As we've discussed many times, there's a definite link between OSA and Diabetes, but I've been mystified why the levels increased AFTER starting therapy. Diet, exercise and weight loss seem to be the best weapons to deal with it, though.

Den

[DyannaK]

This IS an interesting theory. I have just recently started using my CPAP machine. Up to this point I have had no problems with high blood sugar. I have also started a "lifestyle change, fancy word for diet) and am down 20#'s.. I will be interested in seeing how this works for me...

Thank you for posting this Rooster

[tdm5032c]

Maybe I'm way off base, but I can only speak from my own expereince. My aerophagia ranges from annoying to really bad every day from the CPAP no matter what I try it seems. I end up taking a lot of Gas-x or anything else that is effective in getting rid of the gas and indigestion.(Tums, Rolaids, etc.) Despite what I've been told, they really do help me. Anyway, all of these 'treatments' tend to be high in sugar and I would guess can cause higher blood glucose levels.

Anyway, just a thought. I'm sure I'm not the only one with this CPAP induced gas that takes these remedies. My blood sugar is still normal for now. WIth the exception of about three days after my recent open heart surgery. It was pretty elevated for a few days. They checked my ALL the time. My fingers still feel that.

On another note though, I actually got about six hours of solid sleep last night!!! Whoo Hoo! My AHI was .8 and my leak rate was 25.12!!! I'm very happy, as this is about the lowest my AHI for the night has been in a long time!!!

[roster]

Maybe I'm way off base, but I can only speak from my own expereince. My aerophagia ranges from annoying to really bad every day from the CPAP no matter what I try it seems. I end up taking a lot of Gas-x or anything else that is effective in getting rid of the gas and indigestion.(Tums, Rolaids, etc.) ...........

I haven't figured out how to prevent the aerophagia, but I do know how to get rid of it. If anyone is interested, just PM me. And no, this is not a commercial message.

BTW, Extra Strength Rolaids has one gram of sugar per tablet and those tiny little Gas-Ex pills say "may contain sorbitol". I don't think these items are causing high bg levels.

[roster]

Here is another point I forgot about that is in favor of my working hypothesis. All of my morning fasting BG levels are high prediabetic or low diabetic. My postprandial readings are often high normal, occassionally prediabetic and rarely diabetic. So the first morning readings are the real problem ones and later in the day the readings are closer to normal. I maintain that this supports the argument that the bloating of the stomach by CPAP pressure is contributing to higher BG levels.

[dcryandc]

Here is another point I forgot about that is in favor of my working hypothesis. All of my morning fasting BG levels are high prediabetic or low diabetic. My postprandial readings are often high normal, occassionally prediabetic and rarely diabetic. So the first morning readings are the real problem ones and later in the day the readings are closer to normal. I maintain that this supports the argument that the bloating of the stomach by CPAP pressure is contributing to higher BG levels.

rooster - i just had a regular check-up with my primary care doctor - he looked at my BG levels from the last two check-ups and a test he had run for prediabetics, and told me that some people have higher BG levels first thing in the morning, and then they go down as the day goes on, while most people are just the opposite. Turns out that I am one of the rarer ones, with early morning higher BG levels...he said that my test did not show any disposition toward diabetes, and that this is just "normal" for me...so maybe you are the same way: high BG early, lower later in the day, and this is also normal for you.

[Wulfman]

Rising morning glucose levels are caused by one of two things....the Dawn Phenomenon or Somogyi Effect.
You can read about them here:

http://www.diabetic-talk.org/dp.htm


Den

[OldLincoln]

As for the cause and effect relationship of CPAP to Elevated Blood Glucose Levels, I heard a rumor that most people with Elevated Blood Glucose Levels acquire them over time. Perhaps that is your case over the past 3 years - or not.

[Hetron]

I'm diabetic and have been using CPAP since last June. I take Lantus (24 hour insulin). One month after I started using CPAP, I cut my insulin from 110 units/day to 55 units/day-- and my blood sugars have been lower and much more stable.
Go figure?

[DreamStalker]

Here is another point I forgot about that is in favor of my working hypothesis. All of my morning fasting BG levels are high prediabetic or low diabetic. My postprandial readings are often high normal, occassionally prediabetic and rarely diabetic. So the first morning readings are the real problem ones and later in the day the readings are closer to normal. I maintain that this supports the argument that the bloating of the stomach by CPAP pressure is contributing to higher BG levels.

I read Dr. Bernsteins Diabetes Solutuion book (recommended reading) which discusses what Den is talking about "dawn phenomenon".

Have you tried eliminating carbs ... a ketogenic diet (< 50 g carbs per day) ... just to see what happens?

[Woody3]

I have had diabetes at least 9 years and have always had this "dawn effect" I started on cpap 2 years ago and it made no
difference on my "dawn effect" Ofton eating a little first thing in the morning helps blunt this early morning rise in blood
sugar. Doesn't work for everone.

[MrSandman]

http://www.bestsyndication.com/?q=20081 ... levels.htm

[john_dozer]

My family Type II behavior is to actually be to the hypoglycemic side in the morning. So the elevated blood sugar in the morning seems like some other mechanism is at work.

I will say that having been on CPAP about 4-5 months, I've had some Type II pre-diabetic symptoms get worse. Increased feeling of hypoglycemia between meals and a voracious appetite to go with it. I've been considering going to get it checked here soon.

I don't have a bloated stomach feeling in the morning, but I do tend to have a lot of gas where I usually have so little I'm in danger of losing my man card. So I know I am digesting air.