Poor sleep quality is associated with nocturnal glycaemic variability and fear of hypoglycaemia in adults with type 1 diabetes

Martyn‐Nemeth, Pamela; Phillips, Shane A.; Mihăilescu, Dan; Farabi, Sarah S.; Park, Chang Gyu; Lipton, Rebecca B.; Idemudia, Esema; Quinn, Laurie

doi:10.1111/jan.13765

Cited by 38 publications

(62 citation statements)

References 48 publications

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“…Glycaemic fluctuations increase the risk of hypoglycaemia, regardless of the treatment used, including oral hypoglycaemic agents and insulin . Night‐time glycaemic fluctuations are also known to affect the quality of sleep, indicating that prevention of such fluctuations may lead to improved sleep quality and quality of life for patients with diabetes. We found that the addition of canagliflozin to insulin improved the night‐time glycaemic fluctuations, suggesting its beneficial effects on hypoglycaemia and sleep quality.…”

Section: Discussionmentioning

confidence: 99%

Addition of canagliflozin to insulin improves glycaemic control and reduces insulin dose in patients with type 2 diabetes mellitus: A randomized controlled trial

Torimoto

Okada

Goshima

et al. 2019

Diabetes Obesity Metabolism

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The aim of this study was to evaluate the efficacy of canagliflozin in reducing the required insulin dose and the risk of hypoglycaemia in type 2 diabetes (T2D). This study was conducted in patients with T2D treated with insulin. They were randomly assigned to the control (n = 17) and canagliflozin (n = 17, plus 100 mg/day canagliflozin) groups. In both groups, a defined insulin dose adjustment protocol was applied to achieve the same level of glycaemic control. The change from baseline in daily insulin dose was significantly smaller in the canagliflozin group (3.9 units/day) than in the control group (13.4 units/day; P = 0.040). Low blood glucose index and predicted % of blood glucose (BG) <70 mg/dL, which are hypoglycaemia-related variables, worsened significantly in the control group but both remained unchanged in the canagliflozin group. The standard deviation for night-time BG levels improved significantly only in the canagliflozin group. Supplementation of insulin therapy with 100 mg canagliflozin in patients with T2D reduced the required insulin dose and hypoglycaemic risk and flattened night-time glycaemic fluctuations while maintaining the same level of glycaemic control. K E Y W O R D Scanagliflozin, continuous glucose monitoring, hypoglycaemia, insulin therapy, type 2 diabetes

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Section: Discussionmentioning

confidence: 99%

Addition of canagliflozin to insulin improves glycaemic control and reduces insulin dose in patients with type 2 diabetes mellitus: A randomized controlled trial

Torimoto

Okada

Goshima

et al. 2019

Diabetes Obesity Metabolism

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show abstract

“…Similarly, almost 80% of adults with type 1 diabetes believed waking in the night had a negative impact on their usual daily functioning, including mood and happiness, family relationships, work and the ability to exercise regularly and eat healthily . Suboptimal subjective sleep quality has been related to higher levels of daytime sleepiness, fatigue, symptoms of depression and anxiety, and diabetes‐specific distress in adults with type 1 or type 2 diabetes and higher worries about hypoglycaemia in adults with type 1 diabetes . Furthermore, increases in sleep quality have been associated with fewer next‐day diabetes‐specific and general stressors in adults with type 1 diabetes .…”

Section: Overview Of Findings In the Past 25 Yearsmentioning

confidence: 99%

“…rapid declines . Also, higher glycaemic variability (represented by the standard deviation of measured levels) has been related to higher sleep latency and lower subjective sleep quality and duration .…”

Section: Overview Of Findings In the Past 25 Yearsmentioning

confidence: 99%

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Sweet dreams or bitter nightmare: a narrative review of 25 years of research on the role of sleep in diabetes and the contributions of behavioural science

Nefs

Bazelmans²,

Donga

et al. 2019

Diabet. Med.

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The aim of this review was to provide an overview of developments, clinical implications and gaps in knowledge regarding the relationship between diabetes and sleep over the past 25 years, with special focus on contributions from the behavioural sciences. Multiple prospective observational and experimental studies have shown a link between suboptimal sleep and impaired glucose tolerance, decreased insulin sensitivity and the development of type 2 diabetes. While prevalence rates of suboptimal sleep vary widely according to definition, assessment and sample, suboptimal subjective sleep quality appears to be a common reality for one‐third of people with type 1 diabetes and over half of people with type 2 diabetes. Both physiological and psychosocial factors may impair sleep in these groups. In turn, suboptimal sleep can negatively affect glycaemic outcomes directly or indirectly via suboptimal daytime functioning (energy, mood, cognition) and self‐care behaviours. Technological devices supporting diabetes self‐care may have both negative and positive effects. Diabetes and its treatment also affect the sleep of significant others. Research on the merits of interventions aimed at improving sleep for people with diabetes is in its infancy. Diabetes and sleep appear to be reciprocally related. Discussion of sleep deserves a central place in regular diabetes care. Multi‐day, multi‐method studies may shed more light on the complex relationship between sleep and diabetes at an individual level. Intervention studies are warranted to examine the potential of sleep interventions in improving outcomes for people with diabetes.

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“…A study with 48 T1DM patients [ 5 ] measured sleep quality using the Pittsburgh Sleep Quality Index (PSQI) questionnaire, and poor sleep quality was reported by 46% of patients. Similarly, a systematic review and meta-analysis studies using validated questionnaires have shown that T1DM patients with lower HbA1c levels reported good sleep quality, while patients with poor sleep quality have higher HbA1c levels [ 6 ].…”

mentioning

confidence: 99%

The Relationship Between Sleep and Quality of Life in Type 1 Diabetes Patients

et al. 2019

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Poor sleep quality is associated with nocturnal glycaemic variability and fear of hypoglycaemia in adults with type 1 diabetes

Abstract: These findings suggest that glycaemic control and FOH are targets for intervention to improve sleep quality in those with type 1 diabetes.

Cited by 38 publications

References 48 publications

Addition of canagliflozin to insulin improves glycaemic control and reduces insulin dose in patients with type 2 diabetes mellitus: A randomized controlled trial

Addition of canagliflozin to insulin improves glycaemic control and reduces insulin dose in patients with type 2 diabetes mellitus: A randomized controlled trial

Sweet dreams or bitter nightmare: a narrative review of 25 years of research on the role of sleep in diabetes and the contributions of behavioural science

The Relationship Between Sleep and Quality of Life in Type 1 Diabetes Patients

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