BackgroundSleep disturbances are common in individuals with diabetes. Patients with diabetes have higher rates of insomnia, excessive daytime sleepiness and increased incidence of restless leg syndrome. The purpose of our study was to investigate the prevalence and determine the predictors of sleep dysfunction in patients with type 2 diabetes in a southeast Asian Indian population.MethodsWe enrolled 120 patients with type 2 diabetes who attended an endocrinology clinic in a tertiary-care hospital. After we collected their demographic data, we recorded their anthropometric measurements. Fasting, postprandial blood glucose values and glycosylated hemoglobin (HbA1c) values were then obtained. Quality of sleep was evaluated in all the patients through the Pittsburgh Sleep Quality Index (PSQI), which is a questionnaire that assesses sleep quality and disturbances over a monthlong period. A Global Sleep Quality score ≥5 discriminates between good and poor sleepers.ResultsThe mean global PSQI score was 7.08 (standard deviation, 3.89), which suggested poor sleep quality in this population. Sixty-nine percent of patients had a global PSQI score ≥5, indicating that they were "poor sleepers." The global PSQI score positively correlated with the duration of diabetes and was also independent of other variables such as age, gender, body mass index, HbA1c, or medications.ConclusionWe found a high prevalence of sleep dysfunction in patients with type 2 diabetes. We also found a significant correlation between duration of diabetes and quality of sleep, independent of other variables. It is important for physicians to address the quality and duration of sleep in patients with type 2 diabetes.

Altered expression of glucose transporters is a major characteristic of diabetes. Vitamin D has evolved widespread interest in the pathogenesis and prevention of diabetes. The present study was designed to investigate the effect of vitamin D in the overall regulation of muscle cell glucose transporter expression. L6 cells were exposed to type 1 and type 2 diabetic conditions and the effect of calcitriol (1,25, dihydroxy cholicalciferol) on the expression of glucose transporters was studied by real time polymerase chain reaction (RT-PCR). There was a significant decrease in glucose transporter type 1 (GLUT1), GLUT4, vitamin D receptor (VDR), and IR expression in type 1 and 2 diabetic model compared to control group. Treatment of myoblasts with 10-7 M calcitriol for 24 h showed a significant increase in GLUT1, GLUT4, VDR, and insulin receptor (IR) expression. The results indicate a potential antidiabetic function of vitamin D on GLUT1, GLUT4, VDR, and IR by improving receptor gene expression suggesting a role for vitamin D in regulation of expression of the glucose transporters in muscle cells.

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