|
1
|
Goyal S, Rani J, Bhat MA, Vanita V. Genetics of diabetes. World J Diabetes 2023; 14:656-679. [PMID: 37383588 PMCID: PMC10294065 DOI: 10.4239/wjd.v14.i6.656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 03/13/2023] [Accepted: 04/17/2023] [Indexed: 06/14/2023] Open
Abstract
Diabetes mellitus is a complicated disease characterized by a complex interplay of genetic, epigenetic, and environmental variables. It is one of the world's fastest-growing diseases, with 783 million adults expected to be affected by 2045. Devastating macrovascular consequences (cerebrovascular disease, cardiovascular disease, and peripheral vascular disease) and microvascular complications (like retinopathy, nephropathy, and neuropathy) increase mortality, blindness, kidney failure, and overall quality of life in individuals with diabetes. Clinical risk factors and glycemic management alone cannot predict the development of vascular problems; multiple genetic investigations have revealed a clear hereditary component to both diabetes and its related complications. In the twenty-first century, technological advancements (genome-wide association studies, next-generation sequencing, and exome-sequencing) have led to the identification of genetic variants associated with diabetes, however, these variants can only explain a small proportion of the total heritability of the condition. In this review, we address some of the likely explanations for this "missing heritability", for diabetes such as the significance of uncommon variants, gene-environment interactions, and epigenetics. Current discoveries clinical value, management of diabetes, and future research directions are also discussed.
Collapse
Affiliation(s)
- Shiwali Goyal
- Department of Ophthalmic Genetics and Visual Function Branch, National Eye Institute, Rockville, MD 20852, United States
| | - Jyoti Rani
- Department of Human Genetics, Guru Nanak Dev University, Amritsar 143005, Punjab, India
| | - Mohd Akbar Bhat
- Department of Ophthalmology, Georgetown University Medical Center, Washington DC, DC 20057, United States
| | - Vanita Vanita
- Department of Human Genetics, Guru Nanak Dev University, Amritsar 143005, Punjab, India
| |
Collapse
|
|
2
|
Woods NP, Tangpukdee J, Thepa T, Methakanchanasak N. Consequences of Sleep Deprivation in Adult Diabetes Mellitus Type 2 Patients: An Integrative Review. Open Access Maced J Med Sci 2023. [DOI: 10.3889/oamjms.2023.10029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023] Open
Abstract
BACKGROUND: Sleep deprivation in individuals with diabetes mellitus type 2 is more prevalent than in ordinary people. At present, the adverse effects of diabetes type 2 people with sleep disorders and sleep deprivation on blood sugar control are irrefutable. Thorough assessments covering the whole structure should be of concern in health-care treatment. It is precipitated and delivered to the physical, mental health, and social environment, but no systematic review or minimal data were published. Furthermore, it may significantly affect the system more than existing research.
AIM: An integrative review aims to clarify the results or consequences of sleep disturbance/deprivation or insomnia symptoms among diabetes mellitus type 2 patients.
METHODS: The writers implemented a literature search in PubMed, CINAHL, and Medline using the terms DM type 2, insomnia, adult, effect, DM, sleep disturbance, sleep disorder, and a consequence between 2012 and 2022. Inclusion criteria selected through considering the entire article, and providing an abstract, were 20 articles.
RESULTS: Integrative data extraction and information were analyzed thematically. Identified were nine ideas: Association with blood sugar control, blood pressure control, risk of CVD, diabetes self-care behavior, weight gained and Obstructive Sleep Apnea (OSA), lifestyle and physical activity, mood/depression and anxiety symptoms, daily calories distribution, cholesterol/triglyceride, and liver enzyme levels.
CONCLUSION: The adverse effects of sleep deprivation in type 2 diabetes significantly affect all pathophysiologically, mentally, and lifestyle modifications, including diabetes self-care. Therefore, to highlight the importance of promoting optimum sleep in diabetes type2 patients, a health-care system is inevitably as necessary as diet and exercise management.
Collapse
|
|
3
|
Eetemadi A, Tagkopoulos I. Algorithmic lifestyle optimization. J Am Med Inform Assoc 2022; 30:38-45. [PMID: 36308771 PMCID: PMC9748593 DOI: 10.1093/jamia/ocac186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/09/2022] [Accepted: 10/06/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE A hallmark of personalized medicine and nutrition is to identify effective treatment plans at the individual level. Lifestyle interventions (LIs), from diet to exercise, can have a significant effect over time, especially in the case of food intolerances and allergies. The large set of candidate interventions, make it difficult to evaluate which intervention plan would be more favorable for any given individual. In this study, we aimed to develop a method for rapid identification of favorable LIs for a given individual. MATERIALS AND METHODS We have developed a method, algorithmic lifestyle optimization (ALO), for rapid identification of effective LIs. At its core, a group testing algorithm identifies the effectiveness of each intervention efficiently, within the context of its pertinent group. RESULTS Evaluations on synthetic and real data show that ALO is robust to noise, data size, and data heterogeneity. Compared to the standard of practice techniques, such as the standard elimination diet (SED), it identifies the effective LIs 58.9%-68.4% faster when used to discover an individual's food intolerances and allergies to 19-56 foods. DISCUSSION ALO achieves its superior performance by: (1) grouping multiple LIs together optimally from prior statistics, and (2) adapting the groupings of LIs from the individual's subsequent responses. Future extensions to ALO should enable incorporating nutritional constraints. CONCLUSION ALO provides a new approach for the discovery of effective interventions in nutrition and medicine, leading to better intervention plans faster and with less inconvenience to the patient compared to SED.
Collapse
Affiliation(s)
- Ameen Eetemadi
- Department of Computer Science, University of California, Davis, Davis, California, USA
- Genome Center, University of California, Davis, Davis, California, USA
- AI Institute for Next Generation Food Systems (AIFS), University of California, Davis, Davis, California, USA
| | - Ilias Tagkopoulos
- Department of Computer Science, University of California, Davis, Davis, California, USA
- Genome Center, University of California, Davis, Davis, California, USA
- AI Institute for Next Generation Food Systems (AIFS), University of California, Davis, Davis, California, USA
| |
Collapse
|
|
4
|
Koufakis T, Maltese G, Popovic DS, Kotsa K. The importance of sleep quality, quantity, and chronotype in the management of diabetes: Is it time to wake up? J Diabetes 2022; 14:633-634. [PMID: 36084953 PMCID: PMC9512768 DOI: 10.1111/1753-0407.13313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 08/16/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Theocharis Koufakis
- Division of Endocrinology and Metabolism and Diabetes Center, First Department of Internal Medicine, Medical SchoolAristotle University of Thessaloniki, AHEPA University HospitalThessalonikiGreece
| | - Giuseppe Maltese
- Department of Diabetes and EndocrinologyEpsom & St Helier University HospitalsSurreyUK
- Unit for Metabolic Medicine, Cardiovascular Division, Faculty of Life Sciences & MedicineKing's CollegeLondonUK
| | - Djordje S. Popovic
- Clinic for Endocrinology, Diabetes and Metabolic Disorders, Clinical Centre of Vojvodina, Novi Sad, Serbia; Medical FacultyUniversity of Novi SadNovi SadSerbia
| | - Kalliopi Kotsa
- Division of Endocrinology and Metabolism and Diabetes Center, First Department of Internal Medicine, Medical SchoolAristotle University of Thessaloniki, AHEPA University HospitalThessalonikiGreece
| |
Collapse
|
|
5
|
Lawrence A, Khataniar H, Joseph S, Nagarajan T, Umesh S, Michael Raj A J. Sleep impairment: Is it an overlooked burden in painful diabetic peripheral neuropathy? A single-centre, cross-sectional study from south India. Diabetes Metab Syndr 2022; 16:102568. [PMID: 35926431 DOI: 10.1016/j.dsx.2022.102568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/22/2022] [Accepted: 07/06/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS Painful diabetic peripheral neuropathy (PDPN) is a common complication of type 2 diabetes. The unrelenting pain associated with PDPN adversely affects a patient's quality of life. Recognizing the crucial role that sleep plays in the metabolic control of diabetes, this study aims to estimate the prevalence of sleep impairment in painful diabetic peripheral neuropathy (PDPN) and identify the factors associated with it. METHODS We conducted a cross-sectional study among 156 patients in a tertiary care hospital in south India. We recruited consenting adults with PDPN. Sleep quality was analyzed using the Pittsburg sleep quality index (PSQI), a self-rating scale. Hba1c served as a measure of glycemic control. Anxiety and depression were assessed using the hospital anxiety and depression (HAD) scale. Data were analyzed in SPSS 26.0. RESULTS A total of 156 patients were included in the study with a mean age of 58.39 ± 9.12 years. In 151 (96.79%) patients demonstrated sleep impairment with a global PSQI score of 10.92 ± 2.87. Female sex, ischemic heart disease (IHD), high anxiety levels and use of insulin, pregabapentin, and duloxetine; were significantly associated with poor sleep quality (p < 0.05). The median Hba1c was high (9% [7.46-11.1]). However, there was no statistical correlation between the degree of sleep impairment and glycemic control. CONCLUSION We found a high prevalence of sleep impairment in patients with PDPN. Female sex, IHD, high anxiety levels and use of neuropathic drugs were predictors of poor sleep quality.
Collapse
Affiliation(s)
- Adlin Lawrence
- St. Johns Medical College and Hospital, Bengaluru, Karnataka, India
| | | | - Sinimol Joseph
- St. Johns Medical College and Hospital, Bengaluru, Karnataka, India
| | - Thenmozhi Nagarajan
- Department of Internal Medicine, St. Johns Medical College and Hospital, Bengaluru, Karnataka, India
| | - Soumya Umesh
- Department of Internal Medicine, St. Johns Medical College and Hospital, Bengaluru, Karnataka, India.
| | - John Michael Raj A
- Department of Biostatistics, St. Johns Medical College and Hospital, Bengaluru, Karnataka, India
| |
Collapse
|
|
6
|
García-Serrano C, Pujol Salud J, Aran-Solé L, Sol J, Ortiz-Congost S, Artigues-Barberà E, Ortega-Bravo M. Enhancing Night and Day Circadian Contrast through Sleep Education in Prediabetes and Type 2 Diabetes Mellitus: A Randomized Controlled Trial. BIOLOGY 2022; 11:biology11060893. [PMID: 35741413 PMCID: PMC9219735 DOI: 10.3390/biology11060893] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/31/2022] [Accepted: 06/08/2022] [Indexed: 05/01/2023]
Abstract
BACKGROUND Evidence supports a causal relationship between circadian disturbance and impaired glucose homeostasis. METHODS To determine the effect of an educational intervention delivered by primary care nurses to improve sleep hygiene, a parallel, open-label clinical trial in subjects aged 18 and older with impaired fasting glucose (IFG) or type 2 diabetes mellitus (T2DM) was performed. Study variables were sex, age, fasting glucose, glycated haemoglobin A1c (HbA1c), Pittsburgh Sleep Quality Index (PSQI), sleep duration and efficiency, body mass index, antidiabetic treatment, diet and physical exercise. An individual informative educational intervention was carried out following a bidirectional feedback method. The intervention aimed to develop skills to improve sleep through nine simple tips. An analysis of covariance was performed on all the mean centred outcome variables controlling for the respective baseline scores. RESULTS In the intervention group, PSQI dropped, the duration and quality of sleep increased, and a decrease in fasting glucose and in HbA1c levels was observed. CONCLUSION The proposed intervention is effective for improving sleep quality, length and efficiency, and for decreasing fasting glucose and HbA1c levels in only 3 months. These findings support the importance of sleep and circadian rhythm education focused on improving IFG and T2DM.
Collapse
Affiliation(s)
- Cristina García-Serrano
- Balaguer Primary Care Centre, Institut Català de la Salut (ICS), 25600 Lleida, Spain; (J.P.S.); (L.A.-S.); (S.O.-C.)
- Research Group in Therapies in Primary Care (GRETAPS), Fundació Institut Universitari per a la Recerca en Atenció Primària de Salut Jordi Gol i Gurina (IDIAP JGol), 25007 Lleida, Spain; (E.A.-B.); (M.O.-B.)
- Correspondence:
| | - Jesús Pujol Salud
- Balaguer Primary Care Centre, Institut Català de la Salut (ICS), 25600 Lleida, Spain; (J.P.S.); (L.A.-S.); (S.O.-C.)
- Biomedical Research Institute (IRB Lleida), University of Lleida (UdL), 25198 Lleida, Spain
| | - Lidia Aran-Solé
- Balaguer Primary Care Centre, Institut Català de la Salut (ICS), 25600 Lleida, Spain; (J.P.S.); (L.A.-S.); (S.O.-C.)
| | - Joaquim Sol
- Catalan Health Institute (ICS), Primary Care Lleida, Rambla Ferran, 44, 25007 Lleida, Spain;
- Research Support Unit (USR), Fundació Institut Universitari per a la Recerca en Atenció Primària de Salut Jordi Gol i Gurina (IDIAP JGol), 25007 Lleida, Spain
- Metabolic Phisiopathology Group, Department of Experimental Medicine, Biomedical Research Institute (IRB Lleida), University of Lleida (UdL), 25198 Lleida, Spain
| | - Sònia Ortiz-Congost
- Balaguer Primary Care Centre, Institut Català de la Salut (ICS), 25600 Lleida, Spain; (J.P.S.); (L.A.-S.); (S.O.-C.)
| | - Eva Artigues-Barberà
- Research Group in Therapies in Primary Care (GRETAPS), Fundació Institut Universitari per a la Recerca en Atenció Primària de Salut Jordi Gol i Gurina (IDIAP JGol), 25007 Lleida, Spain; (E.A.-B.); (M.O.-B.)
- Catalan Health Institute (ICS), Primary Care Lleida, Rambla Ferran, 44, 25007 Lleida, Spain;
- Research Support Unit (USR), Fundació Institut Universitari per a la Recerca en Atenció Primària de Salut Jordi Gol i Gurina (IDIAP JGol), 25007 Lleida, Spain
| | - Marta Ortega-Bravo
- Research Group in Therapies in Primary Care (GRETAPS), Fundació Institut Universitari per a la Recerca en Atenció Primària de Salut Jordi Gol i Gurina (IDIAP JGol), 25007 Lleida, Spain; (E.A.-B.); (M.O.-B.)
- Catalan Health Institute (ICS), Primary Care Lleida, Rambla Ferran, 44, 25007 Lleida, Spain;
- Research Support Unit (USR), Fundació Institut Universitari per a la Recerca en Atenció Primària de Salut Jordi Gol i Gurina (IDIAP JGol), 25007 Lleida, Spain
| |
Collapse
|
|
7
|
Mirghani HO. The cross talk between chronotype, depression symptomatology, and glycaemic control among sudanese patients with diabetes mellitus: A case-control study. J Family Med Prim Care 2022; 11:330-335. [PMID: 35309608 PMCID: PMC8930107 DOI: 10.4103/jfmpc.jfmpc_656_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 07/07/2021] [Accepted: 11/01/2021] [Indexed: 11/09/2022] Open
Abstract
AIM OF THE STUDY There is an increasing awareness about chronotype and depression among patients with diabetes mellitus as commonly ignored serious association. We aimed to investigate the same among patients with type 2 diabetes mellitus and their relation to glycaemic control. SUBJECTS' AND METHODS This case-control study conducted at two diabetes centers in Omdurman, Sudan during the period from April 2019 to September 2019. Ninety-two patient with type 2 diabetes and 94 controls signed a written informed consent then interviewed using a structured questionnaire based on the morningness-eveningness scale and the 12-item general health questionnaire; A blood sample was taken for the glycated haemoglobin to assess glycaemic control. The Statistical Package for Social Silences was used for Data analysis. RESULTS They were 92 patients with diabetes (58.7% women) and 94 healthy control subjects (52.1% women); matched for ages (57.03 ± 8.59 for diabetic patients and 58.46 ± 10.58 years for control subjects) and sex. Morning chronotype was reported in 95.3% vs. 47.5% and intermediate chronotype was evident in 52.4% vs. 4.3% in controls and patients respectively, P < 0.05. Depression symptomatology was found in 76.1% of patients with diabetes vs. 40.4% of control subjects, P < 0.05. No association was shown between depression symptomatology, chronotype, age, sex, and HbA1c, P > 0.05. CONCLUSION Sudanese patients with diabetes were more likely intermediate, less morning chronotype, and more depressed compared to their counterparts. No association was found between depression symptomatology and other patient's characters. Larger studies investigating the risk behind depression, chrono-nutrition, and social jetlag among patients with diabetes are needed.
Collapse
Affiliation(s)
- Hyder Osman Mirghani
- Department of Internal Medicine, Faculty of Medicine, University of Tabuk, Saudi Arabia
| |
Collapse
|
|
8
|
Moreira CG, Baumann CR, Scandella M, Nemirovsky SI, Leach S, Huber R, Noain D. Closed-loop auditory stimulation method to modulate sleep slow waves and motor learning performance in rats. eLife 2021; 10:e68043. [PMID: 34612204 PMCID: PMC8530509 DOI: 10.7554/elife.68043] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 09/29/2021] [Indexed: 12/26/2022] Open
Abstract
Slow waves and cognitive output have been modulated in humans by phase-targeted auditory stimulation. However, to advance its technical development and further our understanding, implementation of the method in animal models is indispensable. Here, we report the successful employment of slow waves' phase-targeted closed-loop auditory stimulation (CLAS) in rats. To validate this new tool both conceptually and functionally, we tested the effects of up- and down-phase CLAS on proportions and spectral characteristics of sleep, and on learning performance in the single-pellet reaching task, respectively. Without affecting 24 hr sleep-wake behavior, CLAS specifically altered delta (slow waves) and sigma (sleep spindles) power persistently over chronic periods of stimulation. While up-phase CLAS does not elicit a significant change in behavioral performance, down-phase CLAS exerted a detrimental effect on overall engagement and success rate in the behavioral test. Overall CLAS-dependent spectral changes were positively correlated with learning performance. Altogether, our results provide proof-of-principle evidence that phase-targeted CLAS of slow waves in rodents is efficient, safe, and stable over chronic experimental periods, enabling the use of this high-specificity tool for basic and preclinical translational sleep research.
Collapse
Affiliation(s)
- Carlos G Moreira
- Department of Neurology, University Hospital Zurich, University of ZurichZurichSwitzerland
| | - Christian R Baumann
- Department of Neurology, University Hospital Zurich, University of ZurichZurichSwitzerland
- University Center of Competence Sleep & Health Zurich (CRPP), University of ZurichZurichSwitzerland
- Neuroscience Center Zurich (ZNZ)ZurichSwitzerland
| | - Maurizio Scandella
- Department of Neurology, University Hospital Zurich, University of ZurichZurichSwitzerland
| | - Sergio I Nemirovsky
- Institute of Biological Chemistry, School of Exact and Natural Sciences (IQUIBICEN). CONICET – University of Buenos AiresBuenos AiresArgentina
| | - Sven Leach
- Child Development Center, University Children’s Hospital Zurich, University of ZurichZurichSwitzerland
| | - Reto Huber
- University Center of Competence Sleep & Health Zurich (CRPP), University of ZurichZurichSwitzerland
- Neuroscience Center Zurich (ZNZ)ZurichSwitzerland
- Child Development Center, University Children’s Hospital Zurich, University of ZurichZurichSwitzerland
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of ZurichZurichSwitzerland
| | - Daniela Noain
- Department of Neurology, University Hospital Zurich, University of ZurichZurichSwitzerland
- University Center of Competence Sleep & Health Zurich (CRPP), University of ZurichZurichSwitzerland
- Neuroscience Center Zurich (ZNZ)ZurichSwitzerland
| |
Collapse
|
|
9
|
Borse SP, Chhipa AS, Sharma V, Singh DP, Nivsarkar M. Management of Type 2 Diabetes: Current Strategies, Unfocussed Aspects, Challenges, and Alternatives. Med Princ Pract 2020; 30:109-121. [PMID: 32818934 PMCID: PMC8114074 DOI: 10.1159/000511002] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 08/19/2020] [Indexed: 12/13/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) accounts for >90% of the cases of diabetes in adults. Resistance to insulin action is the major cause that leads to chronic hyperglycemia in diabetic patients. T2DM is the consequence of activation of multiple pathways and factors involved in insulin resistance and β-cell dysfunction. Also, the etiology of T2DM involves the complex interplay between genetics and environmental factors. This interplay can be governed efficiently by lifestyle modifications to achieve better management of diabetes. The present review aims at discussing the major factors involved in the development of T2DM that remain unfocussed during the anti-diabetic therapy. The review also focuses on lifestyle modifications that are warranted for the successful management of T2DM. In addition, it attempts to explain flaws in current strategies to combat diabetes. The employability of phytoconstituents as multitargeting molecules and their potential use as effective therapeutic adjuvants to first line hypoglycemic agents to prevent side effects caused by the synthetic drugs are also discussed.
Collapse
Affiliation(s)
- Swapnil P Borse
- AYUSH-Center of Excellence, Center for Complementary and Integrative Health (CCIH), Interdisciplinary School of Health Sciences, Savitribai Phule Pune University (SPPU), Pune, India
- Department of Pharmacology and Toxicology, B. V. Patel Pharmaceutical Education and Research Development (PERD) Centre, Thaltej, India
| | - Abu Sufiyan Chhipa
- Department of Pharmacology and Toxicology, B. V. Patel Pharmaceutical Education and Research Development (PERD) Centre, Thaltej, India
- Institute of Pharmacy, Nirma University, Ahmedabad, India
| | - Vipin Sharma
- Translational Health Science and Technology Institute, Faridabad, India
| | | | - Manish Nivsarkar
- Department of Pharmacology and Toxicology, B. V. Patel Pharmaceutical Education and Research Development (PERD) Centre, Thaltej, India,
| |
Collapse
|
|
10
|
Means C. Letter to the Editor: Mechanisms of increased morbidity and mortality of SARS-CoV-2 infection in individuals with diabetes: what this means for an effective management strategy. Metabolism 2020; 108:154254. [PMID: 32360397 PMCID: PMC7187878 DOI: 10.1016/j.metabol.2020.154254] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 04/23/2020] [Accepted: 04/26/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Casey Means
- Means Health, 407 NW 17(th) Avenue, Suite #5, Portland, OR 97209, USA.
| |
Collapse
|
|
11
|
Hashemipour S, Yazdi Z, Mahabad N. Association of Evening Chronotype with Poor Control of Type 2 Diabetes: Roles of Sleep Duration and Insomnia Level. Int J Endocrinol Metab 2020; 18:e99701. [PMID: 33281907 PMCID: PMC7699824 DOI: 10.5812/ijem.99701] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 08/16/2020] [Accepted: 08/17/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Evening chronotype is usually associated with insomnia and short sleep duration. OBJECTIVES To investigate the independent association of chronotype with diabetes control. METHODS In this cross-sectional study, 140 patients with type 2 diabetes were studied. The insomnia score was examined by a 7-item questionnaire. Also, chronotype was assessed by a 19-item questionnaire, and using the questionnaire, the patients were divided into three groups of morning, intermediate, and evening. This questionnaire has been developed for evaluating the preference for performing mental and physical activities at a special time of day. The Multivariate hierarchical analysis was applied for investigating the independent association of chronotype and glycated hemoglobin (HbA1c). RESULTS The fasting blood glucose and HbA1c levels were significantly different across all the three chronotype groups such that it had the highest value in the evening group and the lowest value in the morning group (FBS = 164.5 ± 34.1 mg/dL and HbA1c = 8.7% ± 1.7, in the evening group, and FBS = 132.7 ± 23.1 mg/dL and HbA1c = 6.9% ± 0.4 in the morning group, P < 0.001). The morning group had longer sleep duration and less insomnia than other groups. Results of the hierarchical regression analysis showed that the chronotype explained 28.4% of the variance of HbA1c. Results of the final model demonstrated that the chronotype had a relationship with HbA1c, independent of body mass index (BMI), time of going to bed, and insomnia score. CONCLUSIONS Evening chronotype is associated with poorer control of diabetes, independent of BMI and sleep variables.
Collapse
Affiliation(s)
- Sima Hashemipour
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Disease, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Zohreh Yazdi
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Disease, Qazvin University of Medical Sciences, Qazvin, Iran
- Corresponding Author: Metabolic Diseases Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
| | - Niloofar Mahabad
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Disease, Qazvin University of Medical Sciences, Qazvin, Iran
| |
Collapse
|
|
12
|
Göke B. [The treatment of diabetes mellitus: myths and evidence]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2020; 63:512-520. [PMID: 32211938 DOI: 10.1007/s00103-020-03124-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
For more than 3500 years, metabolic disorders were recognized by symptoms similar to those indicating diabetes mellitus today. Over centuries, explanations remained elusive and shed sparse light on the origin of the disease and any treatments. The poor prognosis triggered myths and misconceptions, some even lasting until today. Two hundred years ago, major advances were made in the understanding of the pathophysiology, which has led to more successful treatments. Presently, useful preventive, diagnostic, and therapeutic procedures exist. However, old myths and misconceptions still influence the treatments. This article reviews ongoing myths dealing with the genesis and treatment of diabetes and the growing evidence for improved therapies.Increasingly more studies focus on cardiovascular endpoints while considering more realistic therapeutic goals. This paves the way to polyvalent treatment concepts reaching beyond the classic glucocentric treatment concept of type 2 diabetes. The introduction of molecular medicine, the current opportunities and future prospects of new drugs, personalized medicine, and technical innovations prompt hopes and expectations for a change of paradigms in therapeutic concepts. It is quite possible that traditional and newly generated myths will accompany this development. This has to be kept in mind when developing new concepts for treatment.
Collapse
Affiliation(s)
- Burkhard Göke
- Universitätsklinikum Hamburg-Eppendorf, Haus O 35, Martinistraße 52, 20246, Hamburg, Deutschland.
| |
Collapse
|
|
13
|
Fan J, Ding C, Gong W, Yuan F, Zhang Y, Feng G, Song C, Liu A. Association of Sleep Duration and Overweight/Obesity among Children in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061962. [PMID: 32192114 PMCID: PMC7143914 DOI: 10.3390/ijerph17061962] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 03/13/2020] [Accepted: 03/13/2020] [Indexed: 11/30/2022]
Abstract
To investigate the association of sleep duration with overweight and obesity among children aged 6 to 17 years in China, 2010–2012 data from the China National Nutrition and Health Surveillance (CNHHS) were analyzed. A total of 35,414 children were recruited in the survey. Body mass index (BMI) was converted into three categories: normal weight, overweight and obesity. In multinomial logistic regression model, sleep duration was divided into four groups: very short, short, recommended and long. In restricted cubic splines (RCS), sleep duration was examined as a continuous variable in relation to overweight and obesity. In the very short and short groups, sleep duration was a risk factor for obesity after adjusting for the potential impacts of age, gender, residence, family income, leisure sedentary behavior (SB) and leisure exercise, with OR (Odds Ratio) = 3.01 (95% CI (confidence interval): 2.19–4.15) and OR = 1.24 (95% CI: 1.14–1.35), respectively. The adjusted OR of overweight for short sleep duration relative to a recommended sleep duration was 1.17(95% CI: 1.09–1.26). No significant associations of very short sleep with overweight, of long sleep duration with overweight and obesity were found. The RCS curves between sleep duration and overweight and obesity were both inverted J-shaped. To conclude, the shorter the sleep duration, the higher the risk of overweight and obesity in children. Increasing sleep duration would have a positive effect on reducing overweight and obesity rates in Chinese children.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Ailing Liu
- Correspondence: ; Tel.: +86-10-6623-7059
| |
Collapse
|
|
14
|
Brouwer A, van Raalte DH, Rutters F, Elders PJM, Snoek FJ, Beekman ATF, Bremmer MA. Sleep and HbA 1c in Patients With Type 2 Diabetes: Which Sleep Characteristics Matter Most? Diabetes Care 2020; 43:235-243. [PMID: 31719053 DOI: 10.2337/dc19-0550] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 10/07/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Poor sleep has been identified as a risk factor for poor glycemic control in individuals with type 2 diabetes (T2D). As optimal sleep can be characterized in several ways, we evaluated which sleep characteristics are most strongly associated with glycated hemoglobin A1c (HbA1c). RESEARCH DESIGN AND METHODS A total of 172 patients with T2D completed 7-day wrist-actigraphy and sleep questionnaires. Linear regression was used to evaluate associations between sleep measures (total sleep duration, variability in sleep duration, midsleep time, variability in midsleep time, sleep efficiency, subjective sleep quality, and subjective insomnia symptoms) and HbA1c, individually and in concert. RESULTS Variability in sleep duration was individually most strongly associated with HbA1c (β = 0.239; P = 0.002; R 2 = 4.9%), followed by total sleep duration (U-shaped: β = 1.161/β2 = 1.044; P = 0.017/0.032; R 2 = 4.3%), subjective sleep quality (β = 0.191; P = 0.012; R 2 = 3.6%), variability in midsleep time (β = 0.184; P = 0.016; R 2 = 3.4%), and sleep efficiency (β = -0.150; R 2 = 2.3%). Midsleep time and subjective insomnia symptoms were not associated with HbA1c. In combination, variability in sleep duration, total sleep duration, and subjective sleep quality were significantly associated with HbA1c, together explaining 10.3% of the variance in HbA1c. Analyses adjusted for covariates provided similar results, although the strength of associations was generally decreased and showing total sleep duration and subjective sleep quality to be most strongly associated with HbA1c, together explaining 6.0% of the variance in HbA1c. CONCLUSIONS Sleep in general may be a modifiable factor of importance for patients with T2D. The prevention of sleep curtailment may serve as a primary focus in the sleep-centered management of T2D.
Collapse
Affiliation(s)
- Annelies Brouwer
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, and GGZ inGeest, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Daniel H van Raalte
- Department of Internal Medicine, Diabetes Center, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - Femke Rutters
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Petra J M Elders
- Department of General Practice and Elderly Care Medicine, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Frank J Snoek
- Department of Medical Psychology, Amsterdam UMC, Vrije Universiteit and University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Aartjan T F Beekman
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, and GGZ inGeest, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Marijke A Bremmer
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, and GGZ inGeest, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| |
Collapse
|
|
15
|
Characterization of abnormal sleep patterns in patients with obesity, type 2 diabetes, or combined. ALEXANDRIA JOURNAL OF MEDICINE 2018. [DOI: 10.1016/j.ajme.2017.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
|
16
|
Kline CE, Hall MH, Buysse DJ, Earnest CP, Church TS. Poor Sleep Quality is Associated with Insulin Resistance in Postmenopausal Women With and Without Metabolic Syndrome. Metab Syndr Relat Disord 2018; 16:183-189. [PMID: 29649378 DOI: 10.1089/met.2018.0013] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Poor sleep quality has previously been shown to be related to insulin resistance in apparently healthy adults. However, it is unclear whether an association between sleep quality and insulin resistance exists among adults with metabolic syndrome (MetS). METHODS Participants included 347 overweight/obese postmenopausal women without type 2 diabetes (age: 57.5 ± 6.5 years; body mass index [BMI]: 31.7 ± 3.7 kg/m2; 54% with MetS). Sleep quality was assessed with the six-item Medical Outcomes Study Sleep Scale; values were categorized into quartiles. Insulin resistance was calculated from fasting glucose and insulin with the homeostasis model assessment of insulin resistance (HOMA2-IR) method. Analysis of covariance models were used to examine the association between sleep quality and HOMA2-IR after accounting for MetS and covariates (e.g., BMI, cardiorespiratory fitness, and energy intake). RESULTS Women with the worst sleep quality had significantly higher HOMA2-IR values than women in all other quartiles (P ≤ 0.05 for each), and women with MetS had significantly higher HOMA2-IR values than women without MetS (P < 0.0001), but the relationship between sleep quality and HOMA2-IR did not differ between those with or without MetS (P = 0.26). Women with MetS in the worst quartile of sleep quality had higher HOMA2-IR values than all other women (P < 0.02). Taking >30 min to fall asleep, frequent restless sleep, and frequent daytime drowsiness were each related to higher HOMA2-IR values (each P < 0.04). CONCLUSIONS Sleep quality is an important correlate of insulin resistance in postmenopausal women with and without MetS. Intervention studies are needed to determine whether improving sleep improves insulin resistance in populations at elevated cardiometabolic risk.
Collapse
Affiliation(s)
- Christopher E Kline
- 1 Department of Health and Physical Activity, Physical Activity and Weight Management Research Center, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Martica H Hall
- 2 Department of Psychiatry, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Daniel J Buysse
- 2 Department of Psychiatry, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Conrad P Earnest
- 3 Department of Health and Kinesiology, Exercise and Sports Nutrition Laboratory, Texas A&M University , College Station, Texas
| | | |
Collapse
|
|
17
|
Johnson DA, Simonelli G, Moore K, Billings M, Mujahid MS, Rueschman M, Kawachi I, Redline S, Diez Roux AV, Patel SR. The Neighborhood Social Environment and Objective Measures of Sleep in the Multi-Ethnic Study of Atherosclerosis. Sleep 2017; 40:2957268. [PMID: 28364474 DOI: 10.1093/sleep/zsw016] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2017] [Indexed: 01/22/2023] Open
Abstract
Study objectives To investigate cross-sectional associations of neighborhood social environment (social cohesion, safety) with objective measures of sleep duration, timing, and disturbances. Methods A racially/ethnically diverse population of men and women (N = 1949) aged 54 to 93 years participating in the Multi-Ethnic Study of Atherosclerosis Sleep and Neighborhood Ancillary studies. Participants underwent 1-week actigraphy between 2010 and 2013. Measures of sleep duration, timing, and disruption were averaged over all days. Neighborhood characteristics were assessed via questionnaires administered to participants and an independent sample within the same neighborhood and aggregated at the neighborhood (census tract, N = 783) level using empirical Bayes estimation. Multilevel linear regression models were used to assess the association between the neighborhood social environment and each sleep outcome. Results Neighborhood social environment characterized by higher levels of social cohesion and safety were associated with longer sleep duration and earlier sleep midpoint. Each 1 standard deviation higher neighborhood social environment score was associated with 6.1 minutes longer [95% confidence interval (CI): 2.0, 10.2] sleep duration and 6.4 minutes earlier (CI: 2.2, 10.6) sleep midpoint after adjustment for age, sex, race, socioeconomic status, and marital status. These associations persisted after adjustment for other risk factors. Neighborhood social factors were not associated with sleep efficiency or sleep fragmentation index. Conclusions A more favorable neighborhood social environment is associated with longer objectively measured sleep duration and earlier sleep timing. Intervening on the neighborhood environment may improve sleep and subsequent health outcomes.
Collapse
Affiliation(s)
- Dayna A Johnson
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA.,Division of Sleep Medicine Harvard Medical School, Boston, MA
| | - Guido Simonelli
- Department of Behavioral Biology, Walter Reed Army Institute of Research, Silver Spring, MD
| | - Kari Moore
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University,Philadelphia, PA
| | - Martha Billings
- UW Medicine Sleep Center, Division of Pulmonary Critical Care, University of Washington, Seattle, WA
| | | | - Michael Rueschman
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA.,Division of Sleep Medicine Harvard Medical School, Boston, MA
| | - Ana V Diez Roux
- UW Medicine Sleep Center, Division of Pulmonary Critical Care, University of Washington, Seattle, WA
| | - Sanjay R Patel
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA; Research performed at the Division of Sleep and Circadian Disorders at Brigham and Women's Hospital
| |
Collapse
|
|
18
|
Johnson ST, Thiel D, Al Sayah F, Mundt C, Qiu W, Buman MP, Vallance JK, Johnson JA. Objectively measured sleep and health-related quality of life in older adults with type 2 diabetes: a cross-sectional study from the Alberta's Caring for Diabetes Study. Sleep Health 2017; 3:102-106. [PMID: 28346155 DOI: 10.1016/j.sleh.2016.12.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 11/21/2016] [Accepted: 12/04/2016] [Indexed: 01/19/2023]
Abstract
BACKGROUND AND AIM Sleep is an important behavior for metabolic control and mental health in type 2 diabetes. The aim was to examine the relationship of objective estimates of sleep quantity and quality with health-related quality of life (HRQL) in adults with type 2 diabetes. MATERIALS AND METHODS Participants completed a survey where HRQL was measured using the EQ-5D-5 L index score, and the SF-12 v2, which provides physical and mental composite summary (PCS and MCS) scores. Participants also wore wrist actigraphy (Actigraph GT3X+) during sleep to derive estimates of total sleep time (TST), sleep latency (SLAT), and sleep efficiency (SEFF) and wake after sleep onset (WASO). Adjusted multivariable linear regression models were used to examine the associations among actigraphy-derived sleep parameters with PCS, MCS, and EQ-5D-5 L index scores. RESULTS On average, participants (N=168) were 65 years old (standard deviation [SD] 10), 46% were female, with a diabetes duration of 13 years (SD 9) and body mass index of 31 kg/m2 (SD 6.5). Mean (SD) TST and SLAT were 7.5 (1.0) hours and 9.9 (7.6) minutes, respectively, SEFF was 82.7 (6.1) percent and WASO was 86.7 (53.4) minutes. An inverse association between TST and PCS was found where every additional 60 minutes of sleep was associated with 1.3-unit lower PCS (P=.04). SEFF was positively associated with both PCS and MCS, where a 10% greater SEFF was associated with 2.6-unit higher PCS (P=.008), and 1.8-unit higher MCS (P=.056). CONCLUSIONS Among this population, better sleep efficiency was associated with better physical and mental health.
Collapse
Affiliation(s)
| | | | | | - Clark Mundt
- University of Alberta, Edmonton, Alberta, Canada
| | - Weiyu Qiu
- University of Alberta, Edmonton, Alberta, Canada
| | | | | | | |
Collapse
|