Abstract
Aims Sleep duration (SD) has been associated with metabolic outcomes. Is there an independent association between short/long SD and glycemic control (GC) in type 2 diabetes mellitus (T2DM) outpatients, compared to intermediate SD? Employing up-to-date definitions of SD, we comprehensively considered, simultaneously, all known confounding/mediating factors that recently emerged in the literature: age, gender, diet, physical activity, obesity, night pain, nocturnal diuresis, sleep quality, chronotype, sleep apnea, depressive symptoms, alcohol, caffeine, tobacco, number of endocrinologist appointments, T2DM family history, and sleep medication. Methods A cross-sectional study of 140 consecutive T2DM outpatients, ages 40-65, glycohemoglobin (HbA1c) goal ≤ 7. We searched for variables (including HbA1c) significantly associated with short (<6 hours) or long (>8 hours) SD, in comparison to intermediate SD (6-8 hours). Results Higher HbA1c levels increased the chance of belonging to the group that sleeps <6 hours (p ≤ 0.001). Better sleep quality, nocturnal diuresis, and morningness increased the chance of belonging to the group that sleeps >8 hours (p < 0.05). Conclusions There is an independent association between short SD and elevated HbA1c, in real-world T2DM outpatients. Future interventional studies could evaluate weather consistent, long-term sleep extension, from <6 hours to 7–9 hours per 24 hours, improves GC in T2DM outpatients.
Highlights
451 million people worldwide had diabetes mellitus in 2017, according to the International Diabetes Federation [1]
The aim of this study is to determine the association between Sleep duration (SD) and glycemic control (GC) in real-world outpatients already diagnosed with type 2 diabetes mellitus (T2DM) persists, when all confounding and mediating variables that emerged in recent sleep-T2DM literature are simultaneously included in the study analysis
HBA1c level was the only variable that remained in the model (PR 1.27, 95% CI: 1.121.44, p ≤ 0 001), demonstrating that an increase in its value increases the probability that such patients belong in the short SD group, in comparison to the intermediate SD group, independently of other variables
Summary
451 million people worldwide had diabetes mellitus in 2017, according to the International Diabetes Federation [1]. The NSF recommends 7 to 9 hours of sleep per day for the group with ages between 26 and 64 years old, safeguarding, that 6 to 10 hours may be appropriate [5] Such directions originated from specialists’ consensus and were supported by a review of 312 articles published between 2004 and 2014 [5]. A small group of studies [8,9,10,11,12,13] analyzed whether short/long SD is deleterious to glycemic metabolism, in patients already diagnosed with T2DM. The aim of this study is to determine the association between SD and GC in real-world outpatients already diagnosed with T2DM persists, when all confounding and mediating variables that emerged in recent sleep-T2DM literature are simultaneously included in the study analysis
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