Type 1 Diabetes and Obstructive Sleep Apnea

Prior treatment

• Recent major surgery
• Subjects will also be excluded if taking medications that can confound metabolic assessments including systemic glucocorticoids, antipsychotics, thiazide diuretics, beta-blockers, daily use of aminophylline or theophylline, or use of any immunosuppressant.
• Smoking, alcohol or illegal drug abuse

Other illness

• Acute coronary syndrome or stroke past 6 months
• Severe hypertension (blood pressure\>180/105 mmHg)
• Any other significant health condition: unstable angina, heart failure requiring hospitalization in the past 6 months, significant heart block or arrhythmias, NYHA Class\>2, pulmonary disease with dependence on oxygen or daily use of bronchodilators, active or chronic infection, thyroid disease and other endocrine disorders (e.g. Cushing syndrome, acromegaly)
• Major psychiatric disorder

Lab values

• ≥1 trip to emergency room for poor glucose management in the past 6 months
• Liver transaminases \>2 times upper limit of normal,
• Renal transplantation or serum creatinine \>1.5 mg/dL
• Anemia (hemoglobin \<13.0g/dL in men or \<11.6g/dL in women)

Other

• Regular and adherent CPAP use per clinical guidelines
• Requiring oxygen or advanced positive airway pressure modalities during sleep
• Having a 'fall-asleep' or 'near miss' accident in the past 6-months
• Shift work
• Severe hypoglycemia (≥1 episode in the past 3 months or diagnosis of hypoglycemic unawareness)
• Proliferative retinopathy
• Fasting triglycerides \>400mg/dL,
• Currently pregnant or trying to get pregnant or nursing

• Age: 18 to 50 years old
• Type 1 Diabetes on insulin pump therapy and using a CGM device with an GMI (glucose management indicator) between 5.5 and 8.5% with hemoglobin in the normal range at screening
• OSA by home sleep apnea test