Sleep duration, lifestyle intervention and incidence of type 2 diabetes in impaired glucose tolerance: the Finnish Diabetes Prevention Study

Tuomilehto, Henri; Peltonen, M.; Tuomilehto, Jaakko; Lindström, Jaana

doi:10.1016/s1499-2671(09)33078-6

Cited by 14 publications

(30 citation statements)

References 17 publications

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“…Risk for hypercholesterolemia decreased with each additional hour of sleep for females [15]. These findings also support others, from a number of research groups, who found that sleep duration is associated with obesity[12, 20–22, 35, 48, 59], diabetes[16, 19, 25, 27, 41– 43], and cardiovascular disease[15, 24, 26, 31, 34, 36–38, 40]. The current study extends these findings, exploring an alternative measurement for sleep (sleep insufficiency) and comparing it alongside and against sleep duration.…”

Section: Discussionsupporting

confidence: 82%

Sleep duration versus sleep insufficiency as predictors of cardiometabolic health outcomes

et al. 2012

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Objective The objective of the present study was to investigate the relationship between sleep insufficiency and sleep duration, particularly regarding negative cardiometabolic health outcomes already considered to be affected by reduced sleep time. Methods A total of N=30,934 participants from the 2009 Behavioral Risk Factor Surveillance System (BRFSS) answered questions about their sleep duration as well as subjective feelings of sleep insufficiency. Outcomes included body mass index (BMI), obesity (BMI≥30), and history of hypertension, diabetes, hypercholesterolemia, heart attack, and stroke. Linear and logistic regression models examined whether cardiometabolic outcomes were associated with (1) sleep duration alone, (2) sleep insufficiency alone, and (3) the combined effect of sleep duration and sleep insufficiency. Results Results indicated that, when examined alone, sleep duration <5 hours (vs 7 hours) was related to BMI (B=2.716, p<0.01), obesity (B=2.080, p<0.000001), diabetes (B=3.162, p<0.000001), hypertension (B=2.703, p<0.000001), hypercholesterolemia (B=1.922, p<0.00001), heart attack (B=4.704, p<0.000001), and stroke (B=4.558, p<0.000001), and sleep insufficiency (days per week, continuous) was related to BMI (B=0.181, p<.01), obesity (B=1.061, p<0.000001), and hypercholesterolemia (B=1.025, p<.01). All of these relationships remained significant after adjustment for covariates, except for diabetes and sleep duration. Also, after adjustment, a significant relationship between insufficient sleep and hypertension emerged (B=1.039, p<.001). When evaluated together, after adjustment for covariates, significant relationships remained between sleep duration <5 hours (vs 7 hours) and BMI (B=1.266, p<0.05), obesity (B=1.389, p<.05), hypertension (B=1.555, p<0.01), heart attack (B=2.513, p<0.01)and stroke (B=1.807, p<0.05). It should be noted that relationships between sleep duration >9 hours (vs 7 hours) were seen for heart attack (B=1.863, p<0.001) and stroke (B=1.816, p<0.01). In these models, sleep insufficiency was associated with hypercholesterolemia (B=1.031, p<0.01)and hypertension (B=1.027, p<0.05). Conclusions These analyses show that both sleep duration and insufficiency are related to cardiometabolic health outcomes, and that when evaluated together, both variables demonstrate unique effects.

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Section: Discussionsupporting

confidence: 82%

Sleep duration versus sleep insufficiency as predictors of cardiometabolic health outcomes

et al. 2012

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“…The present results extend the results of these previous investigations by showing that short sleep duration is associated with an increased risk of progression of prediabetes to diabetes. We only found one small post hoc analysis of data derived from a lifestyle intervention trial among 522 Finnish obese individuals with impaired glucose tolerance . In that analysis, participants with longer sleep durations in the control group were at greater risk of incident diabetes, contrary to the present findings.…”

Section: Discussioncontrasting

confidence: 94%

Sleep duration and progression to diabetes in people with prediabetes defined by HbA_1c concentration

et al. 2017

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Aims To evaluate the association between sleep duration and the risk of progression to diabetes among people with prediabetes, defined by HbA 1c values.Methods We conducted a cohort study in 17 983 adults who underwent health check-up examinations, including assessments of sleep duration and quality. Diabetes was defined as either HbA 1c ≥48 mmol/mol (6.5%), or the use of antidiabetic medication. Time-dependent proportional hazards models were used to evaluate the association between sleep duration and the risk of progression to diabetes.Results During 31,582 person-years of follow-up, 664 incident cases of diabetes were identified; the incidence rate was 21.0 per 1000 person-years. The multivariate adjusted hazard ratios for progression to diabetes in people with sleep durations of ≤5, 6 and ≥8 h compared with 7 h were 1.68 (95% CI 1.30-2.16), 1.44 (95% CI 1.17-1.76) and 1.23 (95% CI 0.85-1.78), respectively (P for quadratic trend <0.001). This association was partially mediated by biomarkers of adiposity, fatty liver and insulin resistance. ConclusionIn this large study in young and middle-aged adults with prediabetes, we found an association between short sleep duration and the risk of progression to diabetes. Our findings suggest that sufficient sleep duration is important for delaying or preventing the progression of prediabetes to diabetes.

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“…Higher morning glucose levels were associated with increased time awake and decreased time spent in the early, N1 stage of sleep in the preceding overnight period (Figures 1 and 4). The results of this investigation are consistent with the plethora of studies that demonstrate an independent relationship between sleep disorders and altered glucose metabolism [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71][72] ; however, this study represents the first documentation of an association between measures of sleep and glucose dynamics after acute thermal injury. These findings suggest that sleep condition is a contributory factor toward glucose metabolism in the acute postburn period.…”

Section: Discussionsupporting

confidence: 87%

“…[1][2][3][4][5][6][7] Sleep deprivation is a more recent finding postburn. [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] Given the emerging data suggesting a relationship between sleep and impaired glucose metabolism, we hypothesized that sleep disturbance may affect glucose regulation postburn. The metabolic effects of sleep disturbance in burns is not clear despite a plethora of reports in other populations correlating sleep insufficiency with deleterious endocrine consequences, 20,21 including glucose intolerance.…”

mentioning

confidence: 99%

Quantity and Quality of Nocturnal Sleep Affect Morning Glucose Measurement in Acutely Burned Children

Mayes

Gottschlich

Simakajornboon

et al. 2013

Journal of Burn Care & Research

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Hyperglycemia after severe burn injury has long been recognized, whereas sleep deprivation after burns is a more recent finding. The postburn metabolic effects of poor sleep are not clear despite reports in other populations demonstrating the association between sleep insufficiency and deleterious endocrine consequences. The aim of this study was to determine whether a relationship between sleep and glucose dynamics exists in acutely burned children. Two overnight polysomnography runs (2200 to 0600) per subject were conducted in 40 patients with a mean (± SEM) age of 9.4 ± 0.7 years, 50.1 ± 2.9% TBSA burn, and 43.2 ± 3.6% full-thickness injury. Serum glucose was drawn in the morning (0600) immediately after the sleep test. Insulin requirements during the 24-hour period preceding the 0600 glucose measurement were recorded. Generalized linear models were used by the authors to evaluate percent time in each stage of sleep, percent wake time, total sleep time, sleep efficiency, and morning serum glucose, accounting for insulin use. Increased time awake (P = .04, linear; P = .02, quadratic) and reduced time spent in stage 1 sleep (P = .03, linear) were associated with higher glucose levels. Sleep efficiency (P = .01, linear; P = .02, quadratic) and total sleep time (P = .01 linear; P = .02, quadratic) were inversely associated with glucose level. Morning glucose levels appear to be affected by the quality and quantity of overnight sleep in children who have sustained extensive burn injuries. Future research is needed to elucidate the metabolic and neuroendocrine consequences of sleep deprivation on metabolism after burns.

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Sleep duration, lifestyle intervention and incidence of type 2 diabetes in impaired glucose tolerance: the Finnish Diabetes Prevention Study

Cited by 14 publications

References 17 publications

Sleep duration versus sleep insufficiency as predictors of cardiometabolic health outcomes

Sleep duration versus sleep insufficiency as predictors of cardiometabolic health outcomes

Sleep duration and progression to diabetes in people with prediabetes defined by HbA_1c concentration

Quantity and Quality of Nocturnal Sleep Affect Morning Glucose Measurement in Acutely Burned Children

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Sleep duration, lifestyle intervention and incidence of type 2 diabetes in impaired glucose tolerance: the Finnish Diabetes Prevention Study

Cited by 14 publications

References 17 publications

Sleep duration versus sleep insufficiency as predictors of cardiometabolic health outcomes

Sleep duration versus sleep insufficiency as predictors of cardiometabolic health outcomes

Sleep duration and progression to diabetes in people with prediabetes defined by HbA1c concentration

Quantity and Quality of Nocturnal Sleep Affect Morning Glucose Measurement in Acutely Burned Children

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Sleep duration and progression to diabetes in people with prediabetes defined by HbA_1c concentration