Real-World Data in Support of Short Sleep Duration with Poor Glycemic Control, in People with Type 2 Diabetes Mellitus

Abstract

Aims. Sleep duration (SD) has been associated with metabolic outcomes. Is there an independent association between short/long SD and glycemic control (GC) in type 2 diabetes mellitus (T2DM) outpatients, compared to intermediate SD? Employing up-to-date definitions of SD, we comprehensively considered, simultaneously, all known confounding/mediating factors that recently emerged in the literature: age, gender, diet, physical activity, obesity, night pain, nocturnal diuresis, sleep quality, chronotype, sleep apnea, depressive symptoms, alcohol, caffeine, tobacco, number of endocrinologist appointments, T2DM family history, and sleep medication. Methods. A cross-sectional study of 140 consecutive T2DM outpatients, ages 40-65, glycohemoglobin HbA1c goal≤7. We searched for variables (including HbA1c) significantly associated with short (<6 hours) or long (>8 hours) SD, in comparison to intermediate SD (6-8 hours). Results. Higher HbA1c levels increased the chance of belonging to the group that sleeps <6 hours (p≤0.001). Better sleep quality, nocturnal diuresis, and morningness increased the chance of belonging to the group that sleeps >8 hours (p<0.05). Conclusions. There is an independent association between short SD and elevated HbA1c, in real-world T2DM outpatients. Future interventional studies could evaluate weather consistent, long-term sleep extension, from <6 hours to 7–9 hours per 24 hours, improves GC in T2DM outpatients.

Chronotype and well‐being in adults with established type 2 diabetes: A cross‐sectional study

“…28 These factors may contribute to the impaired glycaemic control observed in evening chronotypes. [9][10][11][12] Moreover, increased levels of fatigue experienced by evening chronotypes 10,16 could exacerbate feelings of failure and reduce resilience, leading to a negative emotional impact on how they manage their diabetes. 6,7 Therefore, recognising the different chronotype categories and their association with diabetes-related distress could help people with diabetes and professionals formulate diabetes management plans that are better tailored to the needs of the individual and their chronotype.…”

“…Studies have shown that both lack of sleep and excessive amounts of sleep increase the risk of developing type 2 diabetes and worsen glycaemic control in established type 2 diabetes. [9][10][11][12] Chronotype is largely genetically determined and describes an individuals' inherent pattern for their sleep-wake cycle scheduling and aligns with when they are most alert; early risers and late sleepers define the two extremes of chronotype. 8,9 Chronotype can be determined using the Morningness-Eveningness questionnaire (MEQ) in which a high score relates to morningness tendencies.…”

“…Sleep hygiene has deteriorated in recent decades because of societal changes, 8 revealing associations between sleep habits and cardiometabolic health. Studies have shown that both lack of sleep and excessive amounts of sleep increase the risk of developing type 2 diabetes and worsen glycaemic control in established type 2 diabetes 9–12 …”

The association of self-reported sleep quality and obesity in Kuwait using the Pittsburgh Sleep Quality Index (PSQI)

“…The poor-sleep habits were further reflected in the calculated PSQI score with an average score for the general population of 6.8 (SD± 3.2). Short sleep duration was shown previously to significantly increase the risk of developing type 2 diabetes (4, 24), cardiometabolic risks (25), dyslipidemia (26) and other metabolic syndromes (MetS). Although it is still unclear how sleep duration might drive MetS, it seems that sleep deprivation is becoming a worldwide problem.…”

Possible role of exogenous melatonin in preventing more serious COVID-19 infection in patients with type 2 diabetes mellitus

“…Part of this inflammation is due to hyperglycemia 3 . Another significant part of this inflammation is secondary to sleep disorders (sleep deprivation, insomnia, sleep-related breathing disorders, and circadian rhythm sleep-wake disorders) very prevalent in these patients 4 . In addition to a greater circulation of inflammatory agents, both DM2 and sleep disorders determine a lower amount of an important anti-inflammatory agent: melatonin [5][6][7] .…”