Daytime napping, sleep duration and increased 8-year risk of type 2 diabetes in a British population

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.

Download Full-text

A Novel Risk Score for Type 2 Diabetes Containing Sleep Duration: A 7-Year Prospective Cohort Study among Chinese Participants

Journal of Diabetes Research ◽

10.1155/2020/2969105 ◽

2020 ◽

Vol 2020 ◽

pp. 1-13 ◽

Cited By ~ 1

Author(s):

Xiangtong Liu ◽

Zhiwei Li ◽

Jingbo Zhang ◽

Shuo Chen ◽

Lixin Tao ◽

...

Keyword(s):

Type 2 Diabetes ◽

Cohort Study ◽

Sleep Duration ◽

Health Management ◽

Risk Scores ◽

Net Benefit ◽

Parental History ◽

Net Reclassification Improvement ◽

Increased Risk

Background. Sleep duration is associated with type 2 diabetes (T2D). However, few T2D risk scores include sleep duration. We aimed to develop T2D scores containing sleep duration and to estimate the additive value of sleep duration. Methods. We used data from 43,404 adults without T2D in the Beijing Health Management Cohort study. The participants were surveyed approximately every 2 years from 2007/2008 to 2014/2015. Sleep duration was calculated from the self-reported usual time of going to bed and waking up at baseline. Logistic regression was employed to construct the risk scores. Integrated discrimination improvement (IDI) and net reclassification improvement (NRI) were used to estimate the additional value of sleep duration. Results. After a median follow-up of 6.8 years, we recorded 2623 (6.04%) new cases of T2D. Shorter (both 6-8 h/night and <6 h/night) sleep durations were associated with an increased risk of T2D (odds ratio OR=1.43, 95% confidence interval CI=1.30-1.59; OR=1.98, 95%CI=1.63-2.41, respectively) compared with a sleep duration of >8 h/night in the adjusted model. Seven variables, including age, education, waist-hip ratio, body mass index, parental history of diabetes, fasting plasma glucose, and sleep duration, were selected to form the comprehensive score; the C-index was 0.74 (95% CI: 0.71-0.76) for the test set. The IDI and NRI values for sleep duration were 0.017 (95% CI: 0.012-0.022) and 0.619 (95% CI: 0.518-0.695), respectively, suggesting good improvement in the predictive ability of the comprehensive nomogram. The decision curves showed that women and individuals older than 50 had more net benefit. Conclusions. The performance of T2D risk scores developed in the study could be improved by containing the shorter estimated sleep duration, particularly in women and individuals older than 50.

Download Full-text