Sleep quality and sleep duration, but not circadian parameters are associated with decreased insulin sensitivity in Type 1 diabetes

Rusu, Adriana; Bala, Cornelia; Ciobanu, Dana Mihaela; Cerghizan, Anca; Román, Gabriela

doi:10.1080/07420528.2019.1615501

Cited by 12 publications

(6 citation statements)

References 38 publications

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“…also found that lower PSQI scores are related to MS and several of its components, such as BMI and estimated insulin resistance ( 29 ). A recent study, conducted by Rosu and cols., found a similar result concerning poor sleep and decreased insulin sensitivity using eGDR levels but without the positive correlation between a PSQI and other MS components ( 10 ).…”

Section: Discussionmentioning

confidence: 74%

“…This method allows a better estimation of insulin sensitivity compared with the gold standard test (the euglycemic hyperinsulinemic clamp) and is being considered a predictor of mortality in these individuals ( 9 ). A recent cross-sectional study investigated the relationship between sleep, circadian parameters, and insulin sensitivity as assessed by the estimated glucose disposal rate (eGDR) in 109 adults with T1D and demonstrated that poor sleep quality and sleep duration were negatively associated with eGDR independent of age, gender, smoking status, and body mass index ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

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Relationship between sleep disturbances, lipid profile and insulin sensitivity in type 1 diabetic patients: a cross-sectional study

Mattos

Campos

Fiorini

et al. 2020

Archives of Endocrinology and Metabolism

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Objective The consequences of sleep deprivation in type 1 diabetes (T1D) patients are poorly understood. Our aim was to determine how sleep disorders influence lipid profile and insulin sensitivity in T1D patients. Materials and methods This was a cross-sectional study at a public university hospital. Demographic information and medical histories were obtained during regular scheduled visit of T1D patients to the outpatient clinic. Insulin sensitivity was obtained using the estimated glucose disposal rate (eGDR) formula. Sleep quality was assessed using the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and Berlin Questionnaire. Results The adult participants (n = 66, 62% women) had a median age of 28.0 years (interquartile range 21.8-33.0). Six patients (9%) had metabolic syndrome according to the International Diabetes Federation criteria. Thirty patients (46%) were considered poor sleepers according to the Pittsburgh Sleep Quality Index. The LDL-c and total cholesterol levels of poor sleepers were higher than those of good sleepers (103 v. 81; p = 0.003 and 178.0 v. 159.5 mg/dL; p = 0.009, respectively). Three patients (4%) were at high risk of obstructive sleep apnea syndrome (OSAS) according to the Berlin Questionnaire. The eGDR was lower in the group of patients with high probability of having OSAS (6.0 v. 9.1 mg.kg -1 .min -1 ;p = .03). Conclusions Poor subjective quality of sleep and higher risk of OSAS were correlated with a worsened lipid profile and decreased insulin sensitivity, respectively. Therefore, T1D patients with sleep disturbances might have an increased cardiovascular risk in the future.

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Section: Discussionmentioning

confidence: 74%

Section: Introductionmentioning

confidence: 99%

Relationship between sleep disturbances, lipid profile and insulin sensitivity in type 1 diabetic patients: a cross-sectional study

Mattos

Campos

Fiorini

et al. 2020

Archives of Endocrinology and Metabolism

View full text Add to dashboard Cite

show abstract

“…The following objective sleep-wake characteristics were derived: bedtime, waketime, total sleep time, sleep efficiency (indicator of sleep quality) (%), wake after sleep onset (minutes), awakenings (number), and sleep fragmentation index (% movement index + % fragmentation index). Midsleep time was determined as the midpoint between sleep onset (bedtime plus sleep onset latency) and sleep offset (waketime) (40). Actigraphy provides the greatest agreement and least bias compared with polysomnography in young adults with T1D (41).…”

Section: Objective Sleep-wake Characteristicsmentioning

confidence: 99%

Variations in Sleep Characteristics and Glucose Regulation in Young Adults With Type 1 Diabetes

Griggs

Grey

Crawford

et al. 2021

The Journal of Clinical Endocrinology &Amp; Metabolism

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Context Short sleep duration and sleep disruptions are associated with impaired glucoregulation in type 1 diabetes (T1D). However, the mechanistic pathways between sleep and glucose variability remain unclear. Objective To determine within-and between-person associations between objective sleep-wake characteristics and glucose variability indices. Design/Setting Multilevel models (MLMs) were used to analyze concurrent sleep and glucose patterns over seven days in 42 young adults with T1D in their natural home environment. Patients or Other Participants Young adults with T1D (mean age of 22.2 ± 3.0 years, HbA1C 7.2%, 32.6% male) for at least 6 months with no other medical or major psychiatric comorbidity were included. Main Outcome Measure(s) Sleep-wake characteristics via wrist actigraphy and glucose variability indices via a continuous glucose monitor (CGM). Results Lower sleep efficiency predicted higher glucose variability (less time in range β= .011 and more time in hyperglycemia β= -.011) within-person. A longer wake after sleep onset and more sleep disruptions were associated with higher glucose variability between persons (β= .28 - .31). Higher glucose variability predicted poorer sleep within-person (delayed bedtime, waketime, mid-sleep time, and lower sleep efficiency), while higher glucose variability was associated with poorer sleep and more sleep disruptions between persons (lower sleep efficiency, longer wake after sleep onset, and a higher sleep fragmentation index). Conclusions Clinicians can address the reciprocal nature of the sleep-glucose relationship by optimizing sleep and targeting efforts towards a euglycemic range overnight. Sleep habits are a modifiable personal target in diabetes care.

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“…In keeping, some studies have shown that use of diabetes technologies (including short-term use of HCL) is associated with reductions in diabetes distress (13,14). Among adults with type 1 diabetes, inadequate sleep quality has been associated with increased fear of hypoglycemia, greater nocturnal glycemic variation, and reduced insulin sensitivity (15,16), with experimentally induced sleep deprivation producing a prolonged state of cognitive impairment and hypoglycemic symptoms postrecovery (17). Therefore, HCL systems will be of greatest benefit if, in addition to improving glycemia, they also substantially reduce the psychological and cognitive burden of living with type 1 diabetes.…”

mentioning

confidence: 99%

Six Months of Hybrid Closed-Loop Versus Manual Insulin Delivery With Fingerprick Blood Glucose Monitoring in Adults With Type 1 Diabetes: A Randomized, Controlled Trial

et al. 2020

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OBJECTIVE To investigate glycemic and psychosocial outcomes with hybrid closed-loop (HCL) versus user-determined insulin dosing with multiple daily injections (MDI) or insulin pump (i.e., standard therapy for most adults with type 1 diabetes). RESEARCH DESIGN AND METHODS Adults with type 1 diabetes using MDI or insulin pump without continuous glucose monitoring (CGM) were randomized to 26 weeks of HCL (Medtronic 670G) or continuation of current therapy. The primary outcome was masked CGM time in range (TIR; 70–180 mg/dL) during the final 3 weeks. RESULTS Participants were randomized to HCL (n = 61) or control (n = 59). Baseline mean (SD) age was 44.2 (11.7) years, HbA1c was 7.4% (0.9%) (57 [10] mmol/mol), 53% were women, and 51% used MDI. HCL TIR increased from (baseline) 55% (13%) to (26 weeks) 70% (10%) with the control group unchanged: (baseline) 55% (12%) and (26 weeks) 55% (13%) (difference 15% [95% CI 11, 19]; P < 0.0001). For HCL, HbA1c was lower (median [95% CI] difference −0.4% [−0.6, −0.2]; −4 mmol/mol [−7, −2]; P < 0.0001) and diabetes-specific positive well-being was higher (difference 1.2 [95% CI 0.4, 1.9]; P < 0.0048) without a deterioration in diabetes distress, perceived sleep quality, or cognition. Seventeen (9 device-related) versus 13 serious adverse events occurred in the HCL and control groups, respectively. CONCLUSIONS In adults with type 1 diabetes, 26 weeks of HCL improved TIR, HbA1c, and their sense of satisfaction from managing their diabetes compared with those continuing with user-determined insulin dosing and self-monitoring of blood glucose. For most people living with type 1 diabetes globally, this trial demonstrates that HCL is feasible, acceptable, and advantageous.

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Sleep quality and sleep duration, but not circadian parameters are associated with decreased insulin sensitivity in Type 1 diabetes

Cited by 12 publications

References 38 publications

Relationship between sleep disturbances, lipid profile and insulin sensitivity in type 1 diabetic patients: a cross-sectional study

Relationship between sleep disturbances, lipid profile and insulin sensitivity in type 1 diabetic patients: a cross-sectional study

Variations in Sleep Characteristics and Glucose Regulation in Young Adults With Type 1 Diabetes

Six Months of Hybrid Closed-Loop Versus Manual Insulin Delivery With Fingerprick Blood Glucose Monitoring in Adults With Type 1 Diabetes: A Randomized, Controlled Trial

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