{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T14:02:43Z","timestamp":1775829763438,"version":"3.50.1"},"reference-count":38,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Obstructive sleep apnea (OSA) is a common but underrecognized sleep-related breathing disorder characterized by intermittent hypoxemia and autonomic dysfunction. OSA prevalence and clinical relevance in Type 1 Diabetes Mellitus (T1DM), particularly in relation to diabetes-related vascular complications, remain insufficiently explored. Objective: The aim of this study was to evaluate the prevalence of high-risk OSA in adults with T1DM and controls, and to investigate the association between high-risk OSA and microvascular complications among individuals with T1DM. Methods: In this cross-sectional case\u2013control study, 102 adults with T1DM and 126 controls were included. OSA risk was assessed using the modified Berlin Questionnaire (mBQ). Analyses of vascular complications were restricted to participants with T1DM. Multivariable logistic regression models adjusted for age and sex were used to assess associations, with additional adjustments for body mass index, hypertension, current smoking, alcohol use and glycated hemoglobin A1c. Results: High-risk OSA was identified in 18.6% of individuals with T1DM and 11.9% of controls, with no significant difference between groups. Among participants with T1DM, the prevalence of microvascular complications (retinopathy and\/or neuropathy) was substantially higher in those with high-risk OSA compared with those at low risk (68.4% vs. 18.07%, p &lt;0.001). In univariate logistic regression analysis, high-risk OSA was significantly associated with microvascular complications (odds ratio [OR] 4.85; 95% confidence interval [CI] 1.65\u201314.24; p = 0.004). This association remained significant in the fully adjusted model (OR 5.55; 95% CI 1.36\u201322.65; p = 0.017). Conclusions: High-risk OSA is not more prevalent in adults with T1DM compared with controls; however, among individuals with T1DM, high-risk OSA is strongly and independently associated with microvascular complications. Given the potential contribution of diabetic microvascular and autonomic neuropathy to upper airway dysfunction, the relationship between OSA and vascular complications in T1DM may be bidirectional, warranting further longitudinal investigation.<\/jats:p>","DOI":"10.3390\/jcm15082901","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T13:16:17Z","timestamp":1775826977000},"page":"2901","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of High-Risk Obstructive Sleep Apnea with Microvascular Complications in Adults with Type 1 Diabetes Mellitus: A Case\u2013Control Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2315-9458","authenticated-orcid":false,"given":"Selin","family":"Cakmak Demir","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Koc University School of Medicine, 34010 Istanbul, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adnan","family":"Batman","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Ac\u0131badem University School of Medicine, 34752 Istanbul, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dilek","family":"Yazici","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Koc University School of Medicine, 34010 Istanbul, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oguzhan","family":"Deyneli","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Koc University School of Medicine, 34010 Istanbul, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9067-6538","authenticated-orcid":false,"given":"Y\u00fcksel","family":"Peker","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Koc University School of Medicine, 34010 Istanbul, T\u00fcrkiye"},{"name":"Department of Clinical Sciences, Respiratory Medicine and Allergology, Faculty of Medicine, Lund University, 22100 Lund, Sweden"},{"name":"Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden"},{"name":"Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1389","DOI":"10.1001\/jama.2020.3514","article-title":"Diagnosis and Management of Obstructive Sleep Apnea: A Review","volume":"323","author":"Gottlieb","year":"2020","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1002\/alr.23079","article-title":"International Consensus Statement on Obstructive Sleep Apnea","volume":"13","author":"Chang","year":"2023","journal-title":"Int. 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