Abstract
BackgroundPrevious studies have shown the negative impact of sleep disturbances, specifically insomnia symptoms, on glucose metabolism for people with type 2 diabetes (T2D). People with insomnia symptoms are at risk of poor glycemic control and suboptimal diabetes self-care behavior (DSCB). Investigating the impact of a safe and effective intervention for individuals with T2D and insomnia symptoms on diabetes’ health outcomes is needed. Therefore, the aim of this exploratory study is to examine the effects of Cognitive Behavioral Therapy for Insomnia (CBT-I) on glycemic control, DSCB, and fatigue.MethodsTwenty-eight participants with T2D and insomnia symptoms, after passing an eligibility criteria at a medical research center, were randomly assigned to CBT-I (n = 14) or Health Education (HE; n = 14). The CBT-I and HE groups received 6 weekly one-hour sessions. This Randomized Controlled Trial (RCT) used a non-inferiority framework to test the effectiveness of CBT-I. Validated assessments were administered at baseline and post-intervention to assess glycemic control, DSCB, and fatigue. A Wilcoxon signed-rank test was utilized to compare within-group changes from baseline to post-intervention. A Mann-Whitney test was utilized to measure the between-group differences. Linear regression was used to assess the association between the blood glucose level and the number of days in the CBT-I group.ResultsThe recruitment duration was from October 2018 to May 2019. A total of 13 participants completed the interventions in each group and are included in the final analysis. No adverse events, because of being a part of this RCT, were reported. CBT-I participants showed significantly greater improvement in glycemic control, DSCB, and fatigue. There was a significant association between the number of days in the CBT-I intervention with the blood glucose level before bedtime (B = -0.56, p = .009) and after awakening in the morning (B = -0.57, p = .007).ConclusionsThis study demonstrated a clinically meaningful effect of CBT-I on glycemic control in people with T2D and insomnia symptoms. Also, CBT-I positively impacted daytime functioning, including DSCB and fatigue. Future research is needed to investigate the long-term effects of CBT-I on laboratory tests of glycemic control and to understand the underlying mechanisms of any improvements.Trial registrationClinical Trials Registry (NCT03713996). Retrospectively registered on 22 October 2018,
Highlights
Previous studies have shown the negative impact of sleep disturbances, insomnia symptoms, on glucose metabolism for people with type 2 diabetes (T2D)
A systematic review and meta-analysis of epidemiological studies found that people with type 2 diabetes (T2D) and sleep disturbances were more likely at risk of poor glycemic control as measured by glycated hemoglobin (HbA1c) and suboptimal diabetes self-care behavior (DSCB) [1, 2]
A recent study found that people with T2D and insomnia symptoms had worse scores in several health domains related to DSCB compared to people with T2D without insomnia symptoms [3]
Summary
Previous studies have shown the negative impact of sleep disturbances, insomnia symptoms, on glucose metabolism for people with type 2 diabetes (T2D). People with insomnia symptoms are at risk of poor glycemic control and suboptimal diabetes self-care behavior (DSCB). A systematic review and meta-analysis of epidemiological studies found that people with type 2 diabetes (T2D) and sleep disturbances were more likely at risk of poor glycemic control as measured by glycated hemoglobin (HbA1c) and suboptimal diabetes self-care behavior (DSCB) [1, 2]. Previous studies have shown that insomnia symptoms are common among people with T2D [5, 6], and insomnia itself may independently increase mortality rates [7, 8]. The mechanisms underlying the relationship between T2D and insomnia symptoms are not well understood [10, 11], yet there is a need to identify an effective treatment for insomnia symptoms to improve T2D health outcomes
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
