Julia von Schnurbein1, Claudia Boettcher2, Stephanie Brandt1, Beate Karges3,4, Desiree Dunstheimer5, Angela Galler6, Christian Denzer1, Friederike Denzer1, Heike Vollbach1, Martin Wabitsch1, Till Roenneberg7, Celine Vetter7,8. 1. Pediatric Endocrinology, Diabetes and Obesity unit, University Medical Center Ulm, Ulm, Germany. 2. Division of Pediatric Endocrinology and Diabetology, Centre of Child and Adolescent Medicine, Justus Liebig University Giessen, Gießen, Germany. 3. Department of Pediatrics and Adolescent Medicine, Bethlehem Gesundheitszentrum Stolberg gGmbH, Stolberg, Rhineland, Germany. 4. Division of Endocrinology and Diabetes, RWTH Aachen University, Aachen, Germany. 5. Department of Pediatrics and Adolescent Medicine, Klinikum Augsburg, Augsburg, Germany. 6. Abteilung Interdisziplinär, Charité - Universitätsmedizin Berlin, Paediatric Endocrinology and Diabetology, Sozialpädiatrisches Zentrum, Berlin, Germany. 7. Institute for Medical Psychology, Ludwig-Maximilians-University Munich, München, Germany. 8. Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Abstract
BACKGROUND: Increasing evidence link sleep curtailment and circadian misalignment with adverse metabolic outcome. Adolescents might be most affected, given their late sleep timing and early school and work start times. OBJECTIVE: Our aim was to examine the impact of poor sleeping habits on glycemic control in adolescents with type 1 diabetes. SUBJECTS AND METHODS: This was a non-interventional multicenter study across Germany recruiting pubertally mature adolescents with type 1 diabetes. Medical records were used to collect information on diabetes duration, treatment, and complications. Participants self-reported sleep quality, timing, chronotype, and social jetlag-a measure of circadian misalignment. Hemoglobin A1c (HbA1c) was determined at the time of questionnaire response. We used multivariable linear regression models to examine associations between sleep and glycemic control. RESULTS: A total of 191 patients aged 16.5 years (mean HbA1c 8.0% [64 mmol/mol]) were included in this study. In multivariable adjusted analyses, sleep quality was significantly associated with HbA1c (mean difference; β = -0.07, P = .05). Stratified analysis indicated that this association might be stronger in boys and also in children with migration background. In contrast, neither sleep duration, sleep debt, chronotype, nor social jetlag was associated with HbA1c . Secondary analyses showed that social jetlag was significantly associated with levels of insulin requirements (mean difference; β = 0.035, P = .03). CONCLUSIONS: Our study suggests that poor sleep quality is associated with increased HbA1c in adolescents with type 1 diabetes and that higher levels of circadian misalignment are associated with increased insulin requirements. If replicated, our results indicate a clinical relevance of sleep habits in adolescents with type 1 diabetes.
BACKGROUND: Increasing evidence link sleep curtailment and circadian misalignment with adverse metabolic outcome. Adolescents might be most affected, given their late sleep timing and early school and work start times. OBJECTIVE: Our aim was to examine the impact of poor sleeping habits on glycemic control in adolescents with type 1 diabetes. SUBJECTS AND METHODS: This was a non-interventional multicenter study across Germany recruiting pubertally mature adolescents with type 1 diabetes. Medical records were used to collect information on diabetes duration, treatment, and complications. Participants self-reported sleep quality, timing, chronotype, and social jetlag-a measure of circadian misalignment. Hemoglobin A1c (HbA1c) was determined at the time of questionnaire response. We used multivariable linear regression models to examine associations between sleep and glycemic control. RESULTS: A total of 191 patients aged 16.5 years (mean HbA1c 8.0% [64 mmol/mol]) were included in this study. In multivariable adjusted analyses, sleep quality was significantly associated with HbA1c (mean difference; β = -0.07, P = .05). Stratified analysis indicated that this association might be stronger in boys and also in children with migration background. In contrast, neither sleep duration, sleep debt, chronotype, nor social jetlag was associated with HbA1c . Secondary analyses showed that social jetlag was significantly associated with levels of insulin requirements (mean difference; β = 0.035, P = .03). CONCLUSIONS: Our study suggests that poor sleep quality is associated with increased HbA1c in adolescents with type 1 diabetes and that higher levels of circadian misalignment are associated with increased insulin requirements. If replicated, our results indicate a clinical relevance of sleep habits in adolescents with type 1 diabetes.
Authors: Daniel Combs; James L Goodwin; Stuart F Quan; Wayne J Morgan; Chiu-Hsieh Hsu; Jamie O Edgin; Sairam Parthasarathy Journal: J Clin Sleep Med Date: 2019-01-15 Impact factor: 4.062
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Authors: Renata Aparecida E Silva; Aline De Piano Ganen; Vânia de Fátima Tonetto Fernandes; Nara Michelle de Araújo Evangelista; Carolina Costa Figueiredo; Luciana de Aguiar Pacheco; Guido de Paula Colares Neto Journal: Rev Paul Pediatr Date: 2021-10-04