Association of Self-Reported Sleep and Circadian Measures With Glycemia in Adults With Prediabetes or Recently Diagnosed Untreated Type 2 Diabetes

Abstract

Sleep disturbances and circadian misalignment (social jet lag, late chronotype, or shift work) have been associated with worse glycemic control in type 2 diabetes (T2D). Whether these findings apply to adults with prediabetes is yet unexplored. We hypothesized that self-reported short sleep, poor sleep quality, and/or circadian misalignment are associated with higher glycemia, BMI, and blood pressure (BP) in adults with prediabetes or recently diagnosed, untreated T2D. RESEARCH DESIGN AND METHODSOur cohort included 962 overweight/obese adults ages 20-65 years with prediabetes or recently diagnosed, untreated T2D who completed a 2-h oral glucose tolerance test and validated sleep questionnaires. Independent associations of sleep and circadian variables with glycemia, BMI, and BP were evaluated with regression models. RESULTSThe multiethnic cohort was 55% men, with mean 6 SD age 52.2 6 9.5 years and BMI 34.7 6 5.5 kg/m 2 . Mean sleep duration was 6.6 6 1.3 h. Poor sleep quality was reported by 54% and high risk for obstructive sleep apnea by 64%. HbA 1c was significantly higher in those reporting <5 or >8 h sleep per night. Sleep duration >8 h was also associated with higher fasting glucose and <6 h with higher BMI. Shift work was also associated with higher BMI. Social jet lag and delayed chronotype were associated with higher BP. CONCLUSIONSIn our cohort, self-reported short and long sleep were both associated with adverse measures of glycemia, and short sleep and shift work were associated with higher BMI. Further research using objective measures of sleep is needed to better delineate the relationship between sleep and glycemia in adults with prediabetes or T2D.The obesity epidemic has led to an increase in type 2 diabetes (T2D) (1). There are ;30 million individuals with T2D and nearly 90 million with prediabetes in the U.S. (2). In parallel, there has been an increase in the prevalence of sleep disturbances (3). Chronic partial sleep loss due to bedtime restriction is increasingly prevalent in our

Interaction between obstructive sleep apnea and short sleep duration on insulin resistance: a large-scale study

“…However, another study indicated that OSA, but not short sleep duration, was independently associated with obesity, hypertension, and dyslipidemia [8]. In patients with prediabetes, self-reported short sleep duration was associated with adverse measures of glycemia [9]. However, after considering the effect of OSA, sleep duration was not significantly associated with an abnormal fasting glucose level [10].…”

Greater social jetlag associates with higher HbA1c in adults with type 2 diabetes: a cross sectional study

“…SJL was reported to be associated with higher HbA1c levels in a type 1 diabetes population [19], although another recent study found no relationship between HbA1c and either SJL or chronotype in an adolescent population with type 1 diabetes (SJL was however associated with a requirement for insulin in this cohort [20]). However, recent research failed to identify any association between SJL or chronotype and measures of glycemia in adults with prediabetes and recently diagnosed untreated type 2 diabetes [21].…”

Sleep characteristics and HbA1c in patients with type 2 diabetes on glucose-lowering medication

“…1 This is worrisome as such sleep problems have been linked to impaired glycemic control in patients with T2D. [2][3][4][5][6] For example, a cross-sectional study involving 52 patients with T2D found that OSA was associated with higher hemoglobin A1c (HbA1c) values. 7 Long-term elevated blood glucose levels, as measured by the HbA1c level, have also been reported for patients with T2D suffering from poor sleep quality.…”