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The circadian system is known to play a major role in regulating daily rhythms including feeding behavior, peripheral tissue metabolism, and hormone secretions. Therefore, a team of researchers from the University of Chicago recently investigated whether chronotype and daily caloric distribution are associated with glycemic control in patients with type 2 diabetes independently of sleep disturbances.
194 adults with type 2 diabetes were recruited from endocrinology or primary care clinics at Rush University Medical Center. Height, current medications, and most recent HbA1c values were extracted from the patients’ medical records. Exclusion criteria included pregnancy, inability to understand English or give informed consent, or any neurological or physical impairment that required the participants to depend on others for feeding, nursing home residents, institutionalized patients, and patients receiving alternate routes of nutrition such as tube feeding or parenteral nutrition. Research personnel then interviewed participants using the University of Chicago Diabetes/Quality of Life Survey in order to interpret their diabetes history and management. Sleep quality was assessed for the previous month using the Pittsburgh Sleep Quality Index, with a score of >5 indicating poor sleep quality. Participants reported their usual bed-time, wake-up time, sleep-onset latency, and actual sleep duration on weekdays and weekends over the previous months. Mid-sleep time was calculated as the midpoint between sleep onset and wake time. The primary outcome, mid-sleep time on free (MSF) days was derived from the mid-sleep time on weekend night with a calculated correction for sleep debt. A hierarchical multiple regression analysis was performed to assess if chronotype was independently associated with glycemic control by analyzing the association between MSF and HbA1c, controlling for demographic and sleep variables. Results showed that 20% of the variance in HbA1c could be explained by demographic variables. Of the measured sleep variables, only perceived sleep debt was significantly correlated with glycemic control in bivariate analysis. Each hour delay in MSF was associated with a significantly higher HbA1c of 2.5% of its original value after adjusting for age, sex, race, BMI, depressive symptoms, diabetes complication, insulin use, and sleep variables. Authors of this study believe the results support a role of circadian regulation in glycemic control for patients with type 2 diabetes. Frpm http://www.diabetesincontrol.com http://care.diabetesjournals.org/content/early/2013/03/28/dc12-2697.abstract Published online before print May 1, 2013, doi: 10.2337/dc12-2697. Diabetes Care May 1, 2013 Nyhetsinfo www red DiabetologNytt |
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