The Type 2 Diabetes Prevention with Airway Pressure trial (The DPAP Trial) is a prospective multicenter randomized trial sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases. The trial, which is currently in its planning phase, will investigate whether treatment of obstructive sleep apnea with positive airway pressure therapy is associated with a decrease in the incidence of type 2 diabetes in people with prediabetes.

Prediabetes is a state in which blood sugar levels are higher than normal but not yet high enough to qualify for the diagnosis of type 2 diabetes. People who have prediabetes are more likely to progress to type 2 diabetes. Obstructive sleep apnea is also a common condition which has been linked with prediabetes and the development of diabetes. People with obstructive sleep apnea often snore and have breathing pauses during sleep. Additional symptoms include excessive daytime sleepiness and decreased alertness. Given the disruption of sleep and repetitive drop in oxygen levels during sleep, OSA may increase the risk for developing diabetes through insulin resistance and impairing the secretion of insulin.

The objectives of the DPAP trial are as follows:

  1. To determine whether the addition of positive airway pressure therapy to lifestyle intervention is associated with lower rate of progression from prediabetes to type 2 diabetes among people with prediabetes and moderate-to-severe obstructive sleep apnea.
  2. To assess whether the addition of positive airway pressure therapy to lifestyle intervention, among people with prediabetes and moderate-to-severe obstructive sleep apnea, is associated with greater improvements than with lifestyle intervention alone in: (a) insulin sensitivity, (b) sympathetic nervous system activity; (c) inflammatory markers; (c) resting blood pressure; and (d) daytime function and quality of life.