title: Impact of sleep duration on obesity and the glycemic level in patients with type 2 diabetes: the Fukuoka Diabetes Registry.
abstract: OBJECTIVE
  Few studies are currently available regarding the influence of sleep duration on glycemic control in diabetic patients. The objective of the current study was to examine the relationship between sleep duration, obesity, and the glycemic level in type 2 diabetic patients.
  
  
  METHODS
  A total of 4,870 Japanese type 2 diabetic patients aged ≥20 years were divided into six groups according to their self-reported sleep duration: less than 4.5 h, 4.5-5.4 h, 5.5-6.4 h, 6.5-7.4 h, 7.5-8.4 h, and more than 8.5 h. The associations of sleep duration with obesity and the HbA(1c) levels were examined in a cross-sectional manner.
  
  
  RESULTS
  The HbA(1c) levels showed a quadratic association with sleep duration; namely, a shorter or longer sleep duration was associated with a higher level compared with a sleep duration of 6.5-7.4 h (P for quadratic trend <0.001). This association remained significant after adjusting for potential confounders, including the total energy intake and depressive symptoms. Furthermore, additional adjustments for obesity, which also showed a U-shaped relationship with sleep duration, did not attenuate the U-shaped sleep-HbA(1c) association. A significant interaction between sleep duration and age or the use of insulin was observed for the HbA(1c) levels.
  
  
  CONCLUSIONS
  Sleep duration was shown to have U-shaped associations with obesity and the HbA(1c) levels in type 2 diabetic patients, independent of potential confounders, and therefore may be an important modifiable factor for the clinical management of patients with type 2 diabetes.
authors.affiliation: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Ohkuma
authors.forename: Hiroki
authors.initials: H
authors.lastname: Fujii
authors.forename: Masanori
authors.initials: M
authors.lastname: Iwase
authors.forename: Yohei
authors.initials: Y
authors.lastname: Kikuchi
authors.forename: Shinako
authors.initials: S
authors.lastname: Ogata
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Idewaki
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ide
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Doi
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Hirakawa
authors.forename: Udai
authors.initials: U
authors.lastname: Nakamura
authors.forename: Takanari
authors.initials: T
authors.lastname: Kitazono
mesh_terms: D000367:Age Factors; D001786:Blood Glucose / Q000378:metabolism; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism* / Q000503:physiopathology; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D009765:Obesity / Q000378:metabolism* / Q000503:physiopathology; D012890:Sleep / Q000502:physiology*
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin