The association between glycaemic variability and sleep quality and quantity in adults with type 1 and type 2 diabetes: A systematic review

IF 3.2 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Diabetic Medicine Pub Date : 2024-12-11 DOI:10.1111/dme.15485

Cecilia T. Pham, Aleena Ali, Leonid Churilov, Sara Baqar, Christel Hendrieckx, David N. O'Neal, Mark E. Howard, Elif I. Ekinci

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Abstract

Aims

Individuals with diabetes frequently encounter sleep disturbances, which can detrimentally impact glycaemic management. We reviewed the relationship between sleep outcomes and glycaemic variability in adults with diabetes.

Methods

We systematically searched Medline, EMBASE and Cochrane Library (2002-March 2023) for studies evaluating sleep and glycaemic variability in adults with type 1 and type 2 diabetes. Among the 3049 records, 27 met the inclusion criteria (type 1 diabetes studies = 22). Due to methodological heterogeneity, a qualitative analysis was conducted.

Results

Most studies measuring sleep quality (5 out 7; 71%) reported a significant association with glycaemic variability in type 1 and type 2 diabetes. Sleep duration was not significantly associated with glycaemic variability in type 1 diabetes, whereas other sleep metrics yielded inconclusive results. Hybrid closed-loop pump interventions (n = 12) demonstrated varying sleep outcomes with improved glycaemic variability. Similarly, sleep interventions (n = 3) consistently enhanced sleep but not glycaemic variability. Limitations included moderate to high risk of study bias, confounders, methodological heterogeneity and limited type 2 diabetes data.

Conclusions

A potential association between sleep quality and glycaemic variability exists. However, associations with other sleep metrics remain elusive, with no discernible association between sleep duration and glycaemic variability in type 1 diabetes. Despite advancements in continuous glucose monitoring and ambulatory sleep monitoring, standardised sleep assessment methodologies are lacking in real-world studies. Establishing standard protocols for sleep assessment and defining optimal sleep targets are crucial for meaningful comparisons between studies. Understanding the complex interplay between sleep and glycaemic variability holds promise in improving diabetes management and sleep health.

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成人1型和2型糖尿病患者血糖变异性与睡眠质量和睡眠量之间的关系：一项系统综述

目的：糖尿病患者经常遇到睡眠障碍，这会对血糖管理产生不利影响。我们回顾了成人糖尿病患者睡眠结果与血糖变异性之间的关系。方法：我们系统地检索Medline、EMBASE和Cochrane图书馆（2002- 2023年3月），以评估成人1型和2型糖尿病患者睡眠和血糖变异性的研究。在3049例记录中，27例符合纳入标准（1型糖尿病研究= 22例）。由于方法学的异质性，进行了定性分析。结果：大多数研究测量睡眠质量(5 / 7；71%)报告与1型和2型糖尿病的血糖变异性显著相关。睡眠时间与1型糖尿病患者的血糖变异性没有显著相关性，而其他睡眠指标的结果不确定。混合闭环泵干预（n = 12）显示出不同的睡眠结果与改善的血糖变异性。同样，睡眠干预（n = 3）持续增强睡眠，但没有血糖变异性。局限性包括中度至高风险的研究偏倚、混杂因素、方法学异质性和有限的2型糖尿病数据。结论：睡眠质量和血糖变异性之间存在潜在的关联。然而，与其他睡眠指标的关联仍然难以捉摸，在1型糖尿病患者中，睡眠时间与血糖变异性之间没有明显的关联。尽管在连续血糖监测和动态睡眠监测方面取得了进展，但在现实世界的研究中缺乏标准化的睡眠评估方法。建立睡眠评估的标准协议和确定最佳睡眠目标对于研究之间有意义的比较至关重要。了解睡眠和血糖变异性之间复杂的相互作用有助于改善糖尿病管理和睡眠健康。

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来源期刊

Diabetic Medicine 医学-内分泌学与代谢

CiteScore

7.20

自引率

5.70%

发文量

229

审稿时长

3-6 weeks

期刊介绍： Diabetic Medicine, the official journal of Diabetes UK, is published monthly simultaneously, in print and online editions. The journal publishes a range of key information on all clinical aspects of diabetes mellitus, ranging from human genetic studies through clinical physiology and trials to diabetes epidemiology. We do not publish original animal or cell culture studies unless they are part of a study of clinical diabetes involving humans. Categories of publication include research articles, reviews, editorials, commentaries, and correspondence. All material is peer-reviewed. We aim to disseminate knowledge about diabetes research with the goal of improving the management of people with diabetes. The journal therefore seeks to provide a forum for the exchange of ideas between clinicians and researchers worldwide. Topics covered are of importance to all healthcare professionals working with people with diabetes, whether in primary care or specialist services. Surplus generated from the sale of Diabetic Medicine is used by Diabetes UK to know diabetes better and fight diabetes more effectively on behalf of all people affected by and at risk of diabetes as well as their families and carers.”