Patients with type 2 diabetes with either short or long sleep duration have poor glycemic control
TUESDAY, March 26 (HealthDay News) — Patients with type 2 diabetes with either a short or long sleep duration have significantly higher hemoglobin A1c (A1C) levels compared to patients with intermediate sleep duration, according to research published in the March issue of Diabetes Care.
Toshiaki Ohkuma, M.D., of the Kyushu University in Fukuoka, Japan, and colleagues analyzed data from 4,870 Japanese patients with type 2 diabetes who participated in the Fukuoka Diabetes Registry.
According to the researchers, subjects with short (less than 4.5 hours) or long (greater than 8.5 hours) sleep duration had higher A1C levels compared with subjects sleeping for 6.5 to 7.4 hours, indicating a U-shaped association. The association of sleep duration with obesity and A1C levels was observed to be U-shaped even after adjustments for various confounding variables.
”In conclusion, the current study is the first epidemiological study to demonstrate the U-shaped associations of sleep duration with obesity and glycemic level in patients with type 2 diabetes,” the authors write. ”Our findings suggest that patients with either a short or long sleep duration should be considered high-risk patients for poor glycemic control, and this may have important implications for the clinical management of diabetes.”
Abstract
Impact of Sleep Duration on Obesity and the Glycemic Level in Patients With Type 2 Diabetes
The Fukuoka Diabetes Registry
Toshiaki Ohkuma, MD1,
Hiroki Fujii, MD1,
Masanori Iwase, MD, PHD1,2⇓,
Yohei Kikuchi, MD1,
Shinako Ogata, MD1,
Yasuhiro Idewaki, MD1,
Hitoshi Ide, MD1,
Yasufumi Doi, MD, PHD1,
Yoichiro Hirakawa, MD3,
Udai Nakamura, MD, PHD1 and
Takanari Kitazono, MD, PHD1
+ Author Affiliations
1Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
2Diabetes Center, Hakujyuji Hospital, Fukuoka, Japan
3Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
Abstract
OBJECTIVE Few studies are currently available regarding the influence of sleep duration on glycemic control in diabetic patients. The objective of the current study was to examine the relationship between sleep duration, obesity, and the glycemic level in type 2 diabetic patients.
RESEARCH DESIGN AND METHODS A total of 4,870 Japanese type 2 diabetic patients aged ≥20 years were divided into six groups according to their self-reported sleep duration: less than 4.5 h, 4.5–5.4 h, 5.5–6.4 h, 6.5–7.4 h, 7.5–8.4 h, and more than 8.5 h. The associations of sleep duration with obesity and the HbA1c levels were examined in a cross-sectional manner.
RESULTS The HbA1c levels showed a quadratic association with sleep duration; namely, a shorter or longer sleep duration was associated with a higher level compared with a sleep duration of 6.5–7.4 h (P for quadratic trend <0.001). This association remained significant after adjusting for potential confounders, including the total energy intake and depressive symptoms. Furthermore, additional adjustments for obesity, which also showed a U-shaped relationship with sleep duration, did not attenuate the U-shaped sleep-HbA1c association. A significant interaction between sleep duration and age or the use of insulin was observed for the HbA1c levels.
CONCLUSIONS Sleep duration was shown to have U-shaped associations with obesity and the HbA1c levels in type 2 diabetic patients, independent of potential confounders, and therefore may be an important modifiable factor for the clinical management of patients with type 2 diabetes.
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