Glucose Variations and Activity Are Strongly Coupled in Sleep and Wake in Young Adults With Type 1 Diabetes

Farabi, Sarah S.; Carley, David W.; Quinn, Lauretta

doi:10.1177/1099800416685177

Cited by 19 publications

(31 citation statements)

References 29 publications

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“…As shown in and rapid glucose variations were associated with more movements in young adults with T1D. 7 Specifically, in a study of 15 adolescents with T1D (mean age 12.6 ± 2.9 years), rapid decreases in glucose measured via CGM were associated with more frequent awakenings measured via PSG over 1 night of sleep. 28 We were unable to corroborate our finding that more time spent in hypoglycemia (<70 mg/dL) and higher LBGI were associated with an earlier wake time, but this is likely due to the short concurrent monitoring of sleep and glucose in previous studies (1 night to 60 hours).…”

Section: Multilevel Models Of Glucose Variability and Sleep Indicesmentioning

confidence: 92%

“…4,5 The role of short sleep duration in glucoregulation has been examined extensively both in adults without chronic conditions 6 and in children and adults with T1D. 7 Short sleep duration and more awakenings overnight lead to increases in cortisol and thyroid stimulating hormone and poorer glucose metabolism. 8 Adolescents with T1D have a more pronounced sleep extension on weekends compared to controls without diabetes.…”

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confidence: 99%

“…4 There are only a few studies where the direct effect of glucose fluctuations on sleep was examined among adults with T1D. 7,9 This is likely due to the heavy reliance on HbA1c levels for glycemic control and/or intermittent glucose monitoring 4 with the inability to detect patterns overnight. HbA1c is the gold standard for determining glycemic control in research and practice, yet it does not account for glycemic variability or hypoglycemia in those with T1D.…”

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confidence: 99%

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Daily variations in sleep and glucose in adolescents with type 1 diabetes

2020

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Objective: We used multilevel models (MLMs) to determine person (between-persons) and day level (within-person) associations between glucose variability indices and sleep characteristics in adolescents with type 1 diabetes (T1D). Methods: Adolescents with T1D (Mean age 13.4 ± 1.8 years; 37.8% male; mean HbA1c 8.2 ± 1.2%, 66 mmol/mol) monitored their sleep and glucose patterns concurrently for 3-7 days with a wrist actigraph on their non-dominant wrist and a continuous glucose monitor (CGM) (their own or a provided, blinded CGM). Glucose variability indices included J index, coefficient of variation, low and high blood glucose risk indices (LBGI and HBGI), time in range, and sleep characteristics, including bedtime, wake time, total sleep time, sleep efficiency, wake after sleep onset, awakenings, and sleep fragmentation index. Results: More overall glucose variability was associated within person, more sleep disruptions (more awakenings and more fragmentation) or poorer sleep in our study (earlier wake time or longer wake after sleep onset). Also, more time spent in hypoglycemia <70 mg/dL and a higher LBGI was associated within person with earlier wake time indicating poorer sleep. However, a lower LBGI was associated with a later between-persons wake time. Conclusions: Monitoring over a longer period of time in subsequent studies would allow researchers to determine the within person association between habitual short sleep duration and glucose variability. Providers should regularly assess sleep habits in adolescents as a way to improve glycemic control. Targeting a euglycemic range overnight is also important to promote better sleep and to decrease sleep disruptions.

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Section: Multilevel Models Of Glucose Variability and Sleep Indicesmentioning

confidence: 92%

mentioning

confidence: 99%

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confidence: 99%

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Daily variations in sleep and glucose in adolescents with type 1 diabetes

2020

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“…28 Sleep efficiency was reported in six studies. 20,24,26,27,29,30 Five studies had PSG and actigraphy and one had actigraphy only 31 ) and sleep efficiency ranged from 77 ± 18% 24 to 88.4 ± 5.5% in participants with T1D. 27 Differences in sleep staging were not observed in a descriptive study of 18 young adults with T1D and 9 controls (control vs. T1DM -% of REM sleep: 21.5% ± 5.3% vs. 19.9% ± 7.7%, p = 0.62; % stage N3, 21.7% ± 8.4% vs. 20.6% ± 8.3%: p = 0.77).…”

Section: Objective Sleep Quality and Sleep Efficiency-overall Sleep Qmentioning

confidence: 99%

Sleep characteristics in young adults with type 1 diabetes

Griggs

Redeker

2019

Diabetes Research and Clinical Practice

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Only 14% of young adults with Type 1 Diabetes (T1D) achieve targets for glycemic control (HbA1C < 7.0%), with deterioration over time. Complex cognitive processes required to manage glycemia are vulnerable to sleep deficiency. Using Whittemore and Knafl's approach, we conducted an integrative review of research literature on sleep characteristics and glycemia in these young adults. Quality was assessed using the Mixed Methods Appraisal Tool (v. 2011). Multiple databases were searched for articles published in English in peer-reviewed journals from 2003 to 2018, using search terms 'sleep' and 'T1D' with age limiters 18-40. Of 218 studies initially retrieved, 17 original studies met the inclusion criteria. The following themes were identified in young adults with T1D: (1) They had poorer objective and subjective sleep quality, more variability, and impaired awakening response to hypoglycemia compared with controls; (2) They had poorer glycemic control that was associated with shorter sleep duration, poorer sleep quality, and less time in deep sleep; and (3) Hypoglycemia negatively impacted diabetes management, sleep quality, and next day functioning. Sleep deficiency, as indicated by short sleep duration is associated with a range of negative health outcomes for people with T1D; therefore, optimizing sleep should be a priority in practice and research.

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“…With the improvement of people's diet, its incidence rate and mortality rate increase. It is predicted incidence rate over the world in 2013 will excess 333 million, only secondary to cardiovascular diseases and tumor, the third non-infectious diseases [1,2]. The complications of diabetes are multiple, of which, Diabetic Peripheral Neuropathy (DPN) is one of the most common complications, the main factor causing disability and death of diabetes patients.…”

Section: Introductionmentioning

confidence: 99%

Effects of Tongluotangtai recipe on serum pain substances 5-HT, B-EP, histamine and bradykinin in rats with painful diabetic peripheral neuropathy model of streptozotocin (STZ)

Li¹,

Guanlin²,

Xianghua³

et al. 2018

biomedicalresearch

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Objective: To investigate the effect of Tongluotangtai decoction on 5-HT, β-EP, histamine and bradykinin in serum of STZ rats with pain-related diabetic neuropathy. Methods: The rat model of diabetic peripheral neuropathy was made by intraperitoneal injection of STZ. The rats were divided into control group, model group, Tongluo sugar group and phenytoin. The rats were administrated with saline, Tongluo sugar Thai or phenytoin sodium daily, and the levels of 5-HT, β-EP, histamine and bradykinin in the serum of each group were measured after 3 w, 5 w and 9 w. Results: After 3 w, 5 w and 9 w of drug intervention, the levels of 5-HT, histamine and bradykinin in the model group were significantly higher than those in the control group (P<0.05) and the level of β-EP was significantly reduced. Compared with the model group, the contents of histamine and bradykinin in Tongtao Tangtai group and phenytoin group were significantly decreased and the level of β-EP was significantly reduced. Compared with the rats in the phenytoin group, the contents of histamine and bradykinin in Tongtao Suantai group and phenytoin group were significantly decreased and the level of β-EP was significantly reduced. Conclusion: Tongtao Tangtai decoction can significantly reduce the level of 5-HT, histamine and bradykinin in STZ-induced diabetic neuropathy model rats, increase the content of β-EP and exert a significant anti-pain effect.

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Glucose Variations and Activity Are Strongly Coupled in Sleep and Wake in Young Adults With Type 1 Diabetes

Abstract: Unstructured physical activity and glucose variations demonstrated strong time- and frequency-dependent coupling over a 60-hr period in young adults with T1DM, with sleep/wake differences and circadian modulation evident in this relationship.

Cited by 19 publications

References 29 publications

Daily variations in sleep and glucose in adolescents with type 1 diabetes

Daily variations in sleep and glucose in adolescents with type 1 diabetes

Sleep characteristics in young adults with type 1 diabetes

Effects of Tongluotangtai recipe on serum pain substances 5-HT, B-EP, histamine and bradykinin in rats with painful diabetic peripheral neuropathy model of streptozotocin (STZ)

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