The reciprocal interaction between sleep and type 2 diabetes mellitus: facts and perspectives

Abstract

Type 2 diabetes mellitus is a systemic disease characterized by intolerance to glucose and peripheral resistance to insulin. This endocrine disease affects fundamental mechanisms of the central nervous system and jeopardizes the balance of vital functions such as the cardiovascular and circadian rhythm. The increased prevalence of metabolic disorders in our society is aggravated by endemic voluntary postponement of bedtime and by the current sedentary lifestyle, leading to epidemic proportions of obese people. Diabetes and chronic loss of sleep share the fact that both affect millions and one is detrimental to the other. Indeed, sleep deficits have marked modulatory effects on glucose metabolism and insulin sensitivity and foster metabolic syndrome that culminates in sleep disorders like restless syndrome and sleep apnea, which in turn lead to poor sleep quality. We examine the hypothesis that these two worldwide emerging disorders are due to two interlinked cycles. In our paradigm, we establish an intimate relationship between diabetes and sleep disturbances and postulate possible mechanisms that provide support for this conjecture. In addition, we propose some perspectives about the development of the reciprocal interaction between predictor components of metabolic syndrome and sleep disturbances that lead to poor sleep quality. The ability to predict the development and identify or associate a given mode of sleep disturbance to diabetes would be a valuable asset in the assessment of both. Furthermore, major advances in care coupled with healthy lifestyles can ensure a higher quality of life for people with diabetes.

Psychometric Validation of Stress and Compliance Scale for Diabetes (SCSD) in Penang, Malaysia

“…The current study findings show that the SCSD-10 is a reliable and valid instrument for the assessment of stress & compliance among diabetic patients at community level. Gender difference to perceived stress was observed in this study, that is in the parallel with other studies in the literature [10,12,[14][15] stated that gender influences the appraisal process of stressful events in ways that are consistent with the differing socialization patterns of males and females. Matud (2004) [11] examined gender differences in stress and coping in a large sample (1566 women and 1250 men) between 18 and 65 years old, with different socio-demographic characteristics.…”

“…Aside from the potential physiological impact, chronic stress may interfere with a person's capacity to adhere to lifestyle factors that are essential to diabetic health. Interrupted sleep also results from chronic stress [9], which is particularly concerning in a diabetic population given recent findings that insufficient quantity and/or poor quality of sleep are associated with obesity and metabolic dysfunction [10,11].…”

Impact of Adenotonsillectomy on Insulin Resistance and Lipoprotein Profile in Nonobese and Obese Children

“…Classically, OSA is thought to alter insulin sensitivity and glucose homeostasis via sleep fragmentation 42 and intermittent hypoxia 43 that induce sympathetic activation, 44 catecholamine elevation, oxidative stress and inflammation, 45 increased glucocorticoid levels, 46 and adipose tissue hypoxia. 47 Our findings suggest that there may also be a reciprocal relationship, whereby IR helps maintain OSA independently of obesity.…”

Diabetes mellitus and obstructive sleep apnoea: implications for clinicians

“…12 Further, recent research has brought out several important clinical, epidemiological and public health implications of the association between OSA, the most common form of SDB and type 2 diabetes mellitus (T2DM) which is the most common type of DM. [13][14][15][16][17][18][19][20][21] Some of these key issues regarding the complex relationship between OSA and T2DM are described in this review.…”