Partial Sleep Restriction Decreases Insulin Sensitivity in Type 1 Diabetes

Abstract

OBJECTIVESleep restriction results in decreased insulin sensitivity and glucose tolerance in healthy subjects. We hypothesized that sleep duration is also a determinant of insulin sensitivity in patients with type 1 diabetes.RESEARCH DESIGN AND METHODSWe studied seven patients (three men, four women) with type 1 diabetes: mean age 44 ± 7 years, BMI 23.5 ± 0.9 kg/m2, and A1C 7.6 ± 0.3%. They were studied once after a night of normal sleep duration and once after a night of only 4 h of sleep. Sleep characteristics were assessed by polysomnography. Insulin sensitivity was measured by hyperinsulinemic euglycemic clamp studies with an infusion of [6,6-2H2]glucose.RESULTSSleep duration was shorter in the night with sleep restriction than in the unrestricted night (469 ± 8.5 vs. 222 ± 7.1 min, P = 0.02). Sleep restriction did not affect basal levels of glucose, nonesterified fatty acids (NEFAs), or endogenous glucose production. Endogenous glucose production during the hyperinsulinemic clamp was not altered during the night of sleep restriction compared with the night of unrestricted sleep (6.2 ± 0.8 vs. 6.9 ± 0.6 μmol · kg lean body mass−1 · min−1, NS). In contrast, sleep restriction decreased the glucose disposal rate during the clamp (25.5 ± 2.6 vs. 22.0 ± 2.1 μmol · kg lean body mass−1 · min−1, P = 0.04), reflecting decreased peripheral insulin sensitivity. Accordingly, sleep restriction decreased the rate of glucose infusion by ∼21% (P = 0.04). Sleep restriction did not alter plasma NEFA levels during the clamp (143 ± 29 vs. 133 ± 29 μmol/l, NS).CONCLUSIONSPartial sleep deprivation during a single night induces peripheral insulin resistance in these seven patients with type 1 diabetes. Therefore, sleep duration is a determinant of insulin sensitivity in patients with type 1 diabetes.

Insulin resistance in patients with type 1 diabetes assessed by glucose clamp studies: systematic review and meta-analysis

“…Conversely, insulin resistance can be readily increased in patients with type 1 diabetes by only a single night of partial sleep deprivation (51). These intervention studies indicate that insulin resistance is not a fixed pathophysiological condition in patients with type 1 diabetes.…”

The Relationship Between Sleep Disorders During Pregnancy and

“…Chronic sleep restriction, such as self-imposed short sleep duration, through impact on neuroendocrine functions plays a central role in pathophysiology of overweight and obesity. Chronic sleep disorders including short sleep duration and sleep fragmentation independent of weight and poor glycemic control is a major factor in determining metabolic health (43,44). Pathogenesis process of illness is most likely due to abnormal implantation and abnormal development vessels of the placenta in early periods of pregnancy that this process leads to oxidative stress and inflammation and followed by the release of antiangiogenic agents and widespread disruption of endothelial function.…”

Overweight and Obesity in Youth With Type 1 Diabetes

“…Research exploring the impact of sleep in youth with T1D is beginning to emerge. Sleep restriction was associated with reduced insulin sensitivity (Donga et al, 2010); disrupted sleep was related to glucose variability (Matyka, Crawford, Wiggs, Dunger, & Stores, 2000); and, youth with T1D and those with poorer metabolic control had more bouts of sleep apnea compared to those without T1D or those whose diabetes was in good metabolic control (Villa et al, 2000). Poorer sleep behaviors were also associated with reduced quality of life, educational attainment, and psychological problems (Perfect et al, 2012).…”