Good sleep quality and appropriate sleep duration help maintain glycemic control in diabetes patients

The study found a high prevalence of poor glycemic control in type 2 diabetes patients. The researchers found that an intermediate or low risk of obstructive sleep apnea, and poor sleep quality, both long and short sleep duration, were statistically associated with poor glycemic control.

Poor glycemic control is the most critical tragedy in patients with type 2 diabetes. Sleep disturbance is linked with increased circulating cortisol levels, epinephrine secretion, and sympathetic activity. These physiological conditions are directly or indirectly associated with glucose metabolism in the body cells. Sleep pattern association with glycemic control levels in Ethiopia has yet to be studied.

To address this knowledge gap, Yadelew Yimer Shibabaw, University of Gondar, Gondar, Ethiopia, and colleagues aimed to evaluate glycemic control and its association with sleep duration, sleep quality, and napping among T2DM patients in Felege Hiwot Comprehensive Referral and Specialized Hospital Northwest Ethiopia.

For this purpose, an institutional-based cross-sectional study was performed on 407 patients with type 2 diabetes using a systematic random sampling technique. 5 mL of blood was drawn from each patient before breakfast to determine their fasting blood sugar level. Patients' sleep quality was assessed using the Pittsburg Sleep Quality Index, and the absence or presence of OSA (obstructive sleep apnea) was determined using the STOP-BANG questionnaire.

The authors reported the following findings from the study:

• Glycemic control was poor in 54.05% of the study participants.
• Poor sleep quality, female sex, and short and long sleep durations were all significantly associated with poor glycemic control.
• Compared to males, being female increased the odds of poor glycemic control by 2.7 times (AOR = 2.7).
• Type 2 diabetes patients with poor sleep quality had 3.3 times (AOR = 3.3) higher odds of poor glycemic control than patients with good sleep quality.
• The odds of having poor glycemic control among T2DM patients who were at low risk of OSA and intermediate risk of OSA were decreased by 96% (AOR = 0.03) and 86% (AOR = 0.14) compared to T2DM patients who were at high risk of OSA, respectively. T2DM patients who had short sleep duration (<6 hours) were 8.3 times (AOR = 8.3) more increased chances of poor glycemic control compared to patients who had average sleep duration.
• T2DM patients who had long sleep duration (>8 hours) increased the odds of poor glycemic control by 2.6 times (AOR = 2.6) compared to those who had average sleep duration.
• The chances of having poor glycemic control among T2DM patients who did not take the balanced diet recommended by their physician were increased by 3.8 times (AOR = 3.8).

The findings revealed that female gender, sleeping for short or long periods, and having poor sleep quality, were all statistically significant factors associated with poor glycemic control. "Thus, healthy sleep habits are recommended to enhance glycemic control and prevent complications in T2DM patients," the authors wrote.

They suggested that diabetes patients should be assessed for obstructive sleep apnea and treated accordingly.

"Successive researchers should focus on measuring glycemic control levels using HbA1C and try to measure sleep quality using object sleep measurement tools, line actigraphy and polysomnography," they concluded.

Reference:

Shibabaw, Y. Y., Dejenie, T. A., & Tesfa, K. H. (2023). Glycemic control and its association with sleep quality and duration among type 2 diabetic patients. Metabolism Open, 18, 100246. https://doi.org/10.1016/j.metop.2023.100246