title: Sleep disturbances and low psychological well-being are associated with an increased risk of autoimmune diabetes in adults. Results from the Nord-Trøndelag Health Study.
abstract: OBJECTIVE
  To investigate whether sleep disturbances and low psychological well-being are associated with an increased risk of autoimmune diabetes in adults (including LADA and type 1 diabetes) and type 2 diabetes.
  
  
  METHODS
  We used data from the Norwegian HUNT Study (n = 53,394) and estimated the risk of developing autoimmune diabetes in adults (n = 138) and type 2 diabetes (n = 1895) between 1984 and 2008 in relation to baseline self-reported psychological well-being and sleep problems.
  
  
  RESULTS
  Sleep disturbances and low psychological well-being were associated with an increased risk of autoimmune diabetes (hazard ratio 1.84, 95% confidence interval 1.10-3.09), primarily linked to poor sleep in men (1.83, 1.05-3.20) and low well-being in women (2.50, 1.03-6.54). Similar associations were seen with type 2 diabetes in relation to sleep problems (1.25, 1.08-1.44) in men and low well-being (1.34, 1.16-1.54), in both men and women. In autoimmune diabetes, these factors were associated with lower anti-GAD levels (177 vs. 306 WHO units/ml, p = 0.04).
  
  
  CONCLUSIONS
  Our findings indicate that psychosocial factors influence the risk of autoimmune diabetes in adults, possibly through mechanisms related to insulin resistance. This supports the notion that the aetiology of autoimmune diabetes with adult onset in some respects is similar to that of type 2 diabetes.
authors.affiliation: Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden. lisa.olsson@ki.se
authors.forename: Lisa
authors.initials: L
authors.lastname: Olsson
authors.forename: Anders
authors.initials: A
authors.lastname: Ahlbom
authors.forename: Valdemar
authors.initials: V
authors.lastname: Grill
authors.forename: Kristian
authors.initials: K
authors.lastname: Midthjell
authors.forename: Sofia
authors.initials: S
authors.lastname: Carlsson
mesh_terms: D000328:Adult; D000368:Aged; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology* / Q000209:etiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000503:physiopathology*