Glucose and unstructured physical activity coupling during sleep and wake in young adults with type 1 diabetes

Abstract

Glucose variations have a bidirectional relationship with the sleep/wake and circadian systems in type 1 diabetes (T1D); however, the mechanisms remain unclear. The aim of this study was to describe the coupling between glucose and unstructured physical activity over 168 h in young adults with T1D. We hypothesized that there would be differences in sleep and wake characteristics and circadian variations. Glucose was measured with a continuous glucose monitoring device every 5 min and activity with a non-dominant wrist-worn actigraph in 30-s epochs over 6–14 days. There was substantial glucose and unstructured physical activity coupling during sleep and wake, along with circadian variation based on the wavelet coherence analysis. The extent to which glucose fluctuations result in disrupted sleep over longer than one week should be examined considering the harmful effects on achieving glycemic targets. Further studies are needed to delineate the respective roles of glucose production and utilization and the potential for improved meal and insulin timing to optimize glucose and sleep in this population reliant on exogenous insulin.

A composite measure of sleep health is associated with glycaemic target achievement in young adults with type 1 diabetes

“…This finding is consistent with some previous studies (Griggs, Grey, et al, 2021; Reutrakul et al, 2016), but not others (Perfect et al, 2012; Siwasaranond et al, 2016). Consistent with our findings in the current study, the association between better or more stable timing and lower glycaemia in individuals with T1D has been highlighted in numerous studies (Chontong et al, 2016; Griggs et al, 2020; Griggs et al, 2022; Griggs, Grey, et al, 2021; Griggs, Hickman, et al, 2021; Griggs, Strohl, et al, 2021; Patel et al, 2018; Perfect et al, 2012; Rechenberg et al, 2020; Reutrakul et al, 2016; Reutrakul & Van Cauter, 2014). Beyond cross‐sectional studies, in a recent clinical trial, the chronic sleep restriction with recurrent circadian disruption condition had significantly elevated postprandial plasma glucose levels, whereas the condition with chronic sleep restriction and minimized circadian disruption had no adverse glycaemic effects after 3 weeks of exposure among adults without chronic conditions (Yuan et al, 2021).…”

“…In these studies, poorer individual dimensions of sleep health (e.g. lower satisfaction, lower daytime alertness, variability in timing, lower efficiency and/or shorter duration) were associated with lower achievement of glycaemic targets (Borel et al, 2009; Chontong et al, 2016; Griggs et al, 2020; Griggs et al, 2022; Griggs, Grey, et al, 2021; Griggs, Hickman, et al, 2021; Griggs, Strohl, et al, 2021; Perfect et al, 2012; Rechenberg et al, 2020; Reutrakul et al, 2016).…”

“…There were other studies where the association between a Sleep Health Composite and glycaemia were not available for comparison. Associations between individual sleep health dimensions and glycaemia have varied across other comparison studies (Borel et al, 2009;Chontong et al, 2016;Griggs et al, 2020;Griggs et al, 2022;Perfect et al, 2012;Rechenberg et al, 2020;Reutrakul et al, 2016). In these studies, poorer individual dimensions of sleep health (e.g.…”

Evaluating the influence of sleep quality and quantity on glycemic control in adults with type 1 diabetes

“…To find coherence between the patient's circadian rhythms, they used the cosinor technique (a technique used in circadian physiology) and wavelets. Another similar study using the wavelet coherence analysis is (11). Other studies (12)(13)(14)(15) found significant relations between variability in sleep duration and poor glycemic control.…”

“…Another similar study using the wavelet coherence analysis is Griggs et al. (2022) ( 11 ). Other studies ( 12 – 15 ) found significant relations between variability in sleep duration and poor glycemic control.…”