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

Ana Carolina Musser Tavares De Mattos,Bruna Landeiro Tavares,Yuri Sofiati Campos,Vitória Oliveira Fiorini,Yasmin Sab,Giovanna Aparecida Balarini Lima,Luis Guillermo Coca Velarde,Rubens Antunes Da Cruz

doi:10.20945/2359-3997000000228

Ana Carolina Musser Tavares De Mattos, Bruna Landeiro Tavares + Show 6 more

Open Access

https://doi.org/10.20945/2359-3997000000228

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Abstract

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.

Highlights

Chronic disorders of sleep and wakefulness adversely affect health and daily functioning [1]
To evaluate the presence of metabolic syndrome (MS), we considered the International Diabetes Federation (IDF) consensus criteria, which require the presence of increased waist circumference (WC) (≥ 80cm in women or ≥ 94 cm in men) and two of the following components: a) hypertension, defined as antihypertensive treatment and/or elevated blood pressure; b) dyslipidemia, defined as elevated plasma TG (≥ 150 mg/dL) and/or low high-density lipoprotein cholesterol (HDL-c) cholesterol
Our results demonstrated that a high proportion of participants had sleeping problems with interference in the insulin sensitivity

Summary

Introduction

Chronic disorders of sleep and wakefulness adversely affect health and daily functioning [1]. Considering the size of the problem, awareness among health care professionals and the general public is low [2]. Patients with type 2 diabetes (T2D) present with sleep disturbances more frequently than individuals from the general population, and this is associated with an increase in the prevalence of T2D [3,4,5]. Considering type 1 diabetes (T1D), there are few studies describing sleep disorders and their consequences. Reported that, compared with controls, adult patients with long standing T1D have disturbed subjective sleep quality and are at a higher risk for obstructive sleep apnea syndrome (OSAS) [6]. Donga and cols. showed that partial sleep deprivation in adult T1D patients, even for a single night, reduced peripheral insulin sensitivity

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