The Journal of Clinical Endocrinology and Metabolism Journal Article

Blood Oxygen Saturation in Type 1 Diabetes

January 10, 2023

Jens Christian Laursen, Hatice Isik Mizrak, Huda Kufaishi, Sofie Korsgaard Hecquet, Elisabeth Buur Stougaard, Ninna Hahn Tougaard, Marie Frimodt-Møller, Tine Willum Hansen, Christian Stevns Hansen, Peter Rossing
The Journal of Clinical Endocrinology & Metabolism, Volume 108, Issue 1, January 2023, Pages 99–106
https://doi.org/10.1210/clinem/dgac559

Abstract

Context

Blood oxygen saturation (SpO₂) is lower in type 1 diabetes (T1D) compared with nondiabetic controls. Hypoxia (low tissue oxygenation) is thought to be a risk factor for progression of diabetic complications, but it is unknown whether hypoxemia (low SpO₂) is associated with diabetic complications.

Objective

To test if hypoxemia is associated with presence of diabetic complications in T1D.

Design, Setting, and Methods

Cross-sectional study in persons with T1D divided by a previously suggested threshold in low (<96%) and high (≥96%) SpO₂, measured in the supine position with pulse oximetry. Complications included albuminuria (2 of 3 consecutive measurements ≥30 mg/g), any diabetic retinopathy, neuropathy, and history of cardiovascular disease (CVD). Odds ratios were adjusted for age, diabetes duration, sex, smoking, physical activity, body mass index, systolic blood pressure, and blood hemoglobin.

Results

We included 659 persons, 23 (3.5%) with low and 636 (96.5%) with high SpO₂. In total, 151 (23%) had albuminuria, 233 (36%) had retinopathy, 231 (35%) had neuropathy, and 72 (11%) had CVD. The adjusted odds ratio (95% CI, P value) for low vs high SpO₂ was 3.4 (1.3-8.7, P = 0.01) for albuminuria, 2.8 (1.0-7.5, P = 0.04) for retinopathy, 5.8 (1.8-18.6, P < 0.01) for neuropathy, and nonsignificant for CVD (0.6 [0.2-2.4, P = 0.51]).

Conclusions

SpO₂ below 96% was associated with increased presence of albuminuria, retinopathy, and neuropathy in T1D, but not with CVD. Whether hypoxemia could be a target of intervention to prevent progression in microvascular disease in type 1 diabetes should be investigated.