Sleep and glycemic control in type 1 diabetes.
OBJECTIVE
Our aim in the present study was to elucidate how type 1 diabetes mellitus (T1DM) and sleep parameters interact, which was rarely evaluated up to the moment.


METHODS
Eighteen T1DM subjects without chronic complications, and 9 control subjects, matched for age and BMI, were studied. The following instruments used to evaluate sleep: the Epworth Sleepiness Scale, sleep diaries, actimeters, and polysomnography in a Sleep Lab. Glycemic control in T1DM individuals was evaluated through: A1C, home fingertip glucometer for 10 days (concomitant with the sleep diary and actimeter), and CGM or concomitant with continuous glucose monitoring (during the polysomnography night).


RESULTS
Comparing with the control group, individuals with diabetes presented more pronounced sleep extension from weekdays to weekends than control subjects (p = 0.0303). Among T1DM, glycemic variability (SD) was positively correlated with sleep latency (r = 0.6525, p = 0.0033); full awakening index and arousal index were positively correlated with A1C (r = 0.6544, p = 0.0081; and r = 0.5680, p = 0.0272, respectively); and mean glycemia values were negatively correlated with sleep quality in T1DM individuals with better glycemic control (mean glycemia < 154 mg/dL).


CONCLUSIONS
Our results support the hypothesis of an interaction between sleep parameters and T1DM, where the glycemic control plays an important role. More studies are needed to unveil the mechanisms behind this interaction, which may allow, in the future, clinicians and educators to consider sleep in the effort of regulating glycemic control.
Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, SP, Brazil.
Mark Thomaz Ugliara
MT
Barone
Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brazil.
Daniela
D
Wey
Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Fabiola
F
Schorr
Associação de Diabetes Juvenil, São Paulo, SP, Brazil.
Denise Reis
DR
Franco
Hospital das Clínicas, FMUSP, São Paulo, SP, Brazil.
Mario Kehdi
MK
Carra
Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Geraldo
G
Lorenzi Filho
Escola de Artes, Ciências e Humanidades, USP, São Paulo, SP, Brazil.
Luiz
L
Menna-Barreto
D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D015992:Body Mass Index; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000503:physiopathology*; D005260:Female; D038321:Glycemic Index / Q000502:physiology*; D006801:Humans; D008297:Male; D017286:Polysomnography; D012890:Sleep / Q000502:physiology*; D055815:Young Adult
D001786:Blood Glucose