Sleep complaints and restless legs syndrome in adult type 2 diabetics

Skomro, Robert; Ludwig, Sora; Salamon, Elizabeth; Kryger, Meir H.

doi:10.1016/s1389-9457(01)00110-1

Cited by 149 publications

(133 citation statements)

References 16 publications

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“…A large proportion of patients with insomnia (over 50%) present with comorbidities including cardiovascular disease, mental illness, obesity and diabetes [85]. Conversely, patients with type 2 diabetes often report higher rates of insomnia, with studies indicating that roughly 50% of adult diabetic individuals have insomnia compared with roughly 30% of individuals without diabetes [87]. Other sleep disorders, such as reduced sleep times/insufficient sleep, have been reported among individuals with type 2 diabetes [88].…”

Section: Metabolic Disease and Sleepmentioning

confidence: 99%

Chronomedicine and type 2 diabetes: shining some light on melatonin

et al. 2016

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In mammals, the circadian timing system drives rhythms of physiology and behaviour, including the daily rhythms of feeding and activity. The timing system coordinates temporal variation in the biochemical landscape with changes in nutrient intake in order to optimise energy balance and maintain metabolic homeostasis. Circadian disruption (e.g. as a result of shift work or jet lag) can disturb this continuity and increase the risk of cardiometabolic disease. Obesity and metabolic disease can also disturb the timing and amplitude of the clock in multiple organ systems, further exacerbating disease progression. As our understanding of the synergy between the timing system and metabolism has grown, an interest has emerged in the development of novel clock-targeting pharmaceuticals or nutraceuticals for the treatment of metabolic dysfunction. Recently, the pineal hormone melatonin has received some attention as a potential chronotherapeutic drug for metabolic disease. Melatonin is well known for its sleep-promoting effects and putative activity as a chronobiotic drug, stimulating coordination of biochemical oscillations through targeting the internal timing system. Melatonin affects the insulin secretory activity of the pancreatic beta cell, hepatic glucose metabolism and insulin sensitivity. Individuals with type 2 diabetes mellitus have lower night-time serum melatonin levels and increased risk of comorbid sleep disturbances compared with healthy individuals. Further, reduced melatonin levels, and mutations and/or genetic polymorphisms of the melatonin receptors are associated with an increased risk of developing type 2 diabetes. Herein we review our understanding of molecular clock control of glucose homeostasis, detail the influence of circadian disruption on glucose metabolism in critical peripheral tissues, explore the contribution of melatonin signalling to the aetiology of type 2 diabetes, and discuss the pros and cons of melatonin chronopharmacotherapy in disease management.

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Section: Metabolic Disease and Sleepmentioning

confidence: 99%

Chronomedicine and type 2 diabetes: shining some light on melatonin

et al. 2016

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“…RLS has been reported in association with various conditions, such as iron deficiency, rheumatoid arthritis, uremia, hypothyroidism, and polyneuropathy (15). There have also been reports of an association between RLS and diabetes (16), although this was not confirmed by some investigators (17). Because diabetes is a common cause of polyneuropathy, a higher prevalence of RLS should be expected in the subgroup of RLS patients who also have diabetes.…”

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confidence: 94%

Restless Legs Syndrome and Quality of Sleep in Type 2 Diabetes

et al. 2005

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OBJECTIVE -To investigate the presence of restless legs syndrome (RLS) and the quality of sleep in a population of type 2 diabetic patients.RESEARCH DESIGN AND METHODS -The study population was composed of 100 consecutive patients regularly attending a diabetes clinic at the University Hospital of the Federal University of Ceará. The subjects' quality of sleep was assessed by the Pittsburgh Sleep Quality Index, and excessive daytime sleepiness (EDS) was measured by the Epworth Sleepiness Scale. The RLS was diagnosed using the four minimum criteria defined by the International Restless Legs Syndrome Study Group. Other relevant clinical and laboratory parameters were obtained by interview and chart review.RESULTS -RLS was found in 27% of patients. Poor sleep quality was present in 45% of cases and was associated with age (P ϭ 0.04), peripheral neuropathy (P ϭ 0.001), and RLS (P ϭ 0.000). EDS was found in 26% of patients. Logistic regression analysis revealed an association between RLS and peripheral neuropathy (odds ratio 12.85 [95% CI 2.83-58.40], P ϭ 0.001).CONCLUSIONS -RLS is common in type 2 diabetic patients and can be a major cause of sleep disruption in these patients. Diabetes Care 28:2633-2636, 2005 Diabetes is a lifelong disease of increasing incidence in the Western world and is frequently comorbid with other disorders such as retinopathy, peripheral neuropathy, and nephropathy (1,2). Most patients develop diabetes after age 40 years, and, although much progress has been made in therapy, the majority of diabetic patients continue to die from macrovascular complications (i.e., cardiovascular disease) (3).Recently it has become clear that sleep disturbances (e.g., chronic insomnia, sleep apnea) have a major impact on health and quality of life; this adverse impact can usually be reversed by adequate diagnosis and treatment (4). Neuropathy may also contribute to the significant reduction in quality of life for patients (5).These problems are frequently overlooked on routine medical interviews; furthermore, in some cases, short-term disturbances of sleep may evolve into chronic conditions (6). The indiscriminate use of sleeping pills may further disrupt the sleep-wake cycle and contribute to stress in patients with sleep disorders (7). In type 2 diabetes, sleep disturbances are believed to be common (8) and have been attributed to impaired glucose metabolism and general physical distress (9).Restless legs syndrome (RLS) is a common neurological condition characterized by unpleasant sensations deep inside the legs that occur at rest, especially at bedtime (10,11). The paresthesias are accompanied by an irresistible urge to move the limbs, with movement temporarily relieving the symptoms (12,13). RLS patients experience discomfort and complain of disturbances in initiating and maintaining sleep, sleepiness, and lessrefreshing sleep (14). The intensity of sensory and motor symptoms can vary throughout a patient's lifetime but generally tends to increase with advancing age. RLS has been reported in association ...

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“…But it is equally possible that disruption of metabolism may perturb sleep patterns. For example, adult type 2 diabetics tend to suffer from poor sleep quality and duration (Skomro et al, 2001;Cunha et al, 2008). Thus, although sleep is increasingly associated not only with obesity but also with cardiovascular risk (Knutson, 2010), it remains unclear whether short sleep duration exacerbates these risks, or whether those with perturbed metabolism are prone to each of sleep reduction, weight gain and elevation of metabolic risk.…”

Section: Obesity and Sleepmentioning

confidence: 99%

Obesity and energy balance: is the tail wagging the dog?

Wells¹,

Siervo²

2011

Eur J Clin Nutr

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The scientific study of obesity has been dominated throughout the twentieth century by the concept of energy balance. This conceptual approach, based on fundamental thermodynamic principles, states that energy cannot be destroyed, and can only be gained, lost or stored by an organism. Its application in obesity research has emphasised excessive appetite (gluttony), or insufficient physical activity (sloth), as the primary determinants of excess weight gain, reflected in current guidelines for obesity prevention and treatment. This model cannot explain why weight accumulates persistently rather than reaching a plateau, and underplays the effect of variability in dietary constituents on energy and intermediary metabolism. An alternative model emphasises the capacity of fructose and fructose-derived sweeteners (sucrose, high-fructose corn syrup) to perturb cellular metabolism via modification of the adenosine monophosphate (AMP)/adenosine triphosphate (ATP) ratio, activation of AMP kinase and compensatory mechanisms, which favour adipose tissue accretion and increased appetite while depressing physical activity. This conceptual model implicates chronic hyperinsulinaemia in the presence of a paradoxical state of 'cellular starvation' as a key driver of the metabolic modifications inducing chronic weight gain. We combine evidence from in vitro and in vivo experiments to formulate a perspective on obesity aetiology that emphasises metabolic flexibility and dietary composition rather than energy balance. Using this model, we question the direction of causation of reported associations between obesity and sleep duration or childhood growth. Our perspective generates new hypotheses, which can be tested to improve our understanding of the current obesity epidemic, and to identify novel strategies for prevention or treatment. (2011) 65, 1173-1189; doi:10.1038/ejcn.2011.132; published online 20 July 2011 European Journal of Clinical NutritionKeywords: fructose; obesity; metabolism; energy balance; metabolic flexibility IntroductionThe scientific study of obesity has been dominated throughout the twentieth century by the concept of energy balance. This conceptual approach, based on fundamental thermodynamic principles, states that energy cannot be destroyed, and can only be gained, lost or stored by an organism (Hess, 1838;von Helmholtz, 1847). Its application in obesity research has emphasised excessive appetite, or insufficient physical activity, as the primary determinants of the modification of energy balance leading to excess weight gain (Prentice and Jebb, 1995), reflected in current protocols for obesity prevention and treatment. As we review below, this model cannot explain why weight accumulates persistently in individuals, rather than reaching a plateau when weight gain re-establishes the balance between energy intake and expenditure. The energy balance approach also underplays the effect of particular dietary components (for example, carbohydrates, amino-acids and fatty acids) on energy metabolism and fuel oxidati...

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Sleep complaints and restless legs syndrome in adult type 2 diabetics

Cited by 149 publications

References 16 publications

Chronomedicine and type 2 diabetes: shining some light on melatonin

Chronomedicine and type 2 diabetes: shining some light on melatonin

Restless Legs Syndrome and Quality of Sleep in Type 2 Diabetes

Obesity and energy balance: is the tail wagging the dog?

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