title: Are late-night eating habits and sleep duration associated with glycemic control in adult type 1 diabetes patients treated with insulin pumps?
abstract: OBJECTIVE
  Little is known about the impact of sleep duration and late-night snacking on glycemic control in patients with type 1 diabetes using insulin pumps. The aim of the present study was to examine whether late-night eating habits and short sleep duration are associated with glycemic control in continuous subcutaneous insulin infusion-treated type 1 diabetic patients.
  
  
  METHODS
  We included 148 consecutive adult type 1 diabetic subjects using an insulin pump (100 women and 48 men). Participants completed a questionnaire regarding sleep duration (classified as short if ≤6 h) and late-night snacking. Other sources of information included medical records and data from blood glucose meters. Glycemic control was assessed by glycated hemoglobin (HbA1c) levels and mean self-monitoring of blood glucose (SMBG) readings.
  
  
  RESULTS
  The mean age of patients was 26 years, mean type 1 diabetes duration was 13.4 years and mean HbA1c level was 7.2%. In a univariate regression analysis, sleep duration was a predictor of both HbA1c (β = 0.51, P = 0.01) and SMBG levels (β = 11.4, P = 0.02). Additionally, an association was found between frequent late-night snacking and higher SMBG readings (often snacking β = 18.1, P = 0.05), but not with increased HbA1c levels. In the multivariate linear regression, independent predictors for HbA1c and SMBG were sleep duration and patient age. In a univariate logistic regression, sleep duration and frequency of late-night snacking were not predictors of whether HbA1c target levels were achieved.
  
  
  CONCLUSIONS
  Short sleep duration, but not late-night snacking, seems to be associated with poorer glycemic control in type 1 diabetic patients treated with continuous subcutaneous insulin infusion.
authors.affiliation: Department of Metabolic Diseases, Jagiellonian University Medical College Krakow, Poland.
authors.forename: Bartlomiej
authors.initials: B
authors.lastname: Matejko
authors.affiliation: Department of Metabolic Diseases, Jagiellonian University Medical College Krakow, Poland ; University Hospital Krakow, Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Kiec-Wilk
authors.affiliation: Department of Metabolic Diseases, Jagiellonian University Medical College Krakow, Poland ; University Hospital Krakow, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Szopa
authors.affiliation: Department of Metabolic Diseases, Jagiellonian University Medical College Krakow, Poland ; University Hospital Krakow, Poland.
authors.forename: Iwona
authors.initials: I
authors.lastname: Trznadel Morawska
authors.affiliation: Department of Metabolic Diseases, Jagiellonian University Medical College Krakow, Poland ; University Hospital Krakow, Poland.
authors.forename: Maciej T
authors.initials: MT
authors.lastname: Malecki
authors.affiliation: Department of Metabolic Diseases, Jagiellonian University Medical College Krakow, Poland ; University Hospital Krakow, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Klupa
keywords: Glycated hemoglobin; Insulin pump therapy; Sleep duration