Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder. Although frequently undiagnosed, OSA is highly prevalent and presents most often with excessive daytime sleepiness (EDS). While obesity is the major predisposing factor, patients with OSA and EDS are at increased risk of other conditions, including cardiovascular disease, type 2 diabetes, cognitive impairment. and depression. Significant consequences include morbidity and mortality from the associated conditions in addition to personal and societal consequences of cognitive impairment, such as driving and workplace accidents. Primary care physicians are ideally placed to screen for OSA and EDS in patients who present with commonly comorbid conditions such as obesity, cardiovascular disease, metabolic syndrome, and depression. Conversely, treatment of OSA and associated EDS might help alleviate significant comorbidities and their clinical and societal consequences.

Maintaining tight glycemic control is an important issue for patients with type 2 diabetes. Empowering patients to be actively involved in the management of their diabetes can improve glycemic control through education, communication, and the use of patient-friendly insulin regimens. The primary care physician plays an important role in helping patients manage their disease by encouraging initiation of treatment with insulin analogs, which are more convenient, more predictable, and better tolerated than traditional human insulin therapies. Modern insulin delivery devices, such as insulin pens, may also help improve patient acceptance of insulin therapy.