Sleep Affects Diabetes

HeConnection-Sleep Affects DiabetesHealth-e-Solutions comment:  Joy Pape, RN, BSN, CDE, WOCN, CFCN, Contributing Nursing Editor for the PRESENT Diabetes newsletter wrote the following article about how sleep affects diabetes. The statistics associating poor quality and quantity of sleep to diabetes are alarming, such as: people who have difficulty staying asleep have an 84% increased odds of developing diabetes. we should take sleep seriously if we are serious about optimal health and blood sugar management..

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Kristen L. Knutson, PhD., Assistant Professor of Medicine, The University of Chicago Department of Medicine presented a topic that is always interesting to me, Sleep Deficiency and Diabetes. She told us that, due to the prevalence of diabetes, it is important to identify modifiable risk factors. Sleep deficiency is a potential risk factor that has been receiving a lot of attention. Sleep deficiency can be the result of too little sleep (not sleeping long enough), impaired sleep quality, or a sleep disorder such as obstructive sleep apnea and/or insomnia.

Dr. Knutson discussed these points:

  • Sleep reduction reduces insulin sensitivity.
  • Sleep restriction decreases leptin (a hormone that decreases appetite), and increases ghrelin (a hormone that increases appetite). Appetite for specific food types change after short sleep versus long sleep. For example, short sleep increases appetite for sweets, salty foods, and starchy foods. It decreases one’s appetite for fruits, vegetables, meat, and dairy.
  • A summary of laboratory studies of sleep loss showed a 40% decrease in glucose tolerance, a 30% decrease in acute insulin response (AIRg), an 18% reduction in leptin, a 28% increase in ghrelin, a 23% increase in global appetite, a 32% increase in appetite for high carb foods, and an 18% increase in appetite for other foods.
  • Short sleep is related to obesity. A meta-analysis showed that, in children, short sleepers had an 89% increased odds of being obese and adults who are short sleepers have a 55% increased odds of being obese.
  • Sleep may be a diabetes risk. Short sleepers have a 28% increased odds of developing diabetes. People who have difficulty falling asleep have a 57% increased odds of developing diabetes, and people who have difficulty staying asleep have an 84% increased odds of developing diabetes.
  • Sleep quality may be related to glucose metabolism in persons with diabetes. Poor sleep quality appears to be associated with worse glycemic control in persons with diabetes. A causal direction cannot be determined at this time. It may be that poor sleep impairs glycemic control, and/or poorly controlled diabetes can impair sleep. More research should be done to determine if improving sleep can help control diabetes.
  • Obstructive sleep apnea (OSA) is related to type 2 diabetes. There is a high prevalence (over 50%) of OSA in people in people who have type 2 diabetes. Most cases of OSA are undiagnosed. It is still uncertain which comes first – the OSA or the type 2 diabetes – and it is still unclear if OSA is an independent risk factor for type 2 diabetes. Treating OSA seems to improve glycemia, but adherence is a problem. We need better treatment with greater adherence.

In conclusion, Dr. Knutson said

  • Sleep loss and poor sleep quality may increase the risk of diabetes and obesity.
  • Persons with diabetes have increased risk of poor sleep and OSA, which may impair their ability to control their diabetes.

So what does this mean? I think it means we should take sleep seriously. We need to assess our sleep length, quality, risk for OSA and, if diagnosed, our adherence to treatment.

Health-e-Solutions-Sleep-Health-Diabetes-Sleep Affects DiabetesHealth-e-Solutions comment: Sleep is one of the five pillars supporting thriving health and better #BloodSugarControl in the Health-e-Solutions lifestyle. Diabetes and sleep problems often go hand in hand. Diabetes can cause sleep loss, and there is evidence that poor sleep increases your risk of developing diabetes. Research is revealing the links between sleep and diabetes and suggests that we should use sleep like diet and exercise to prevent or #ControlDiabetesNaturally. Make sleep a priority! We’ll help you learn why and how with our downloadable, printable special report on Sleep, Health and Diabetes

References:

  1. Buxton, O. M., M. Pavlova, et al. (2010). “Sleep Restriction for One Week Reduces Insulin Sensitivity in Healthy Men.” Diabetes.
  2. Cappuccio, F. P., L. D’Elia, et al. (2009). “Quantity and quality of sleep and incidence of type 2 diabetes: a systematic review and meta-analysis. “Diabetes Care.
  3. Spiegel, K., R. Leproult, et al. (2004). “Leptin levels are dependent on sleep duration: Relationships with sympathovagal balance, carbohydrate regulation, cortisol, and thyrotropin. “Journal of Clinical Endocrinology and Metabolism 89(11): 5762-5771.
  4. Knutson, K. (2010). “Sleep duration and cardiometabolic risk: a review of the epidemiologic evidence. “Best Practice & Research Clinical Endocrinology & Metabolism in press.
  5. Knutson, K. L., A. M. Ryden, et al. (2006). “Role of sleep duration and quality in the risk and severity of type 2 diabetes mellitus. “Arch Intern Med 166(16): 1768-1774.
  6. Knutson, K. L., K. Spiegel, et al. (2007). “The metabolic consequences of sleep deprivation. ” Sleep Med Rev 11(3): 163-178.
  7. Punjabi, N. M., E. Shahar, et al. (2004). “Sleep-disordered breathing, glucose intolerance, and insulin resistance: the Sleep Heart Health Study. ” Am J Epidemiol 160(6): 521-530.