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Complications
Association between Sleep Quality and Painless Diabetic Peripheral Neuropathy Assessed by Current Perception Threshold in Type 2 Diabetes Mellitus
Dughyun Choi, Bo-Yeon Kim, Chan-Hee Jung, Chul-Hee Kim, Ji-Oh Mok
Diabetes Metab J. 2021;45(3):358-367.   Published online August 6, 2020
DOI: https://doi.org/10.4093/dmj.2019.0219
  • 5,858 View
  • 153 Download
  • 1 Web of Science
  • 3 Crossref
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background

It is known that the painful sensation of diabetic peripheral neuropathy (DPN) results in sleep problems in type 2 diabetes mellitus (T2DM). However, it is not known that the painless DPN also is associated with poor sleep quality in T2DM. The purpose of the current study was to investigate the association between painless DPN and poor sleep quality in T2DM.

Methods

A total of 146 patients of T2DM who do not have any painful symptoms of DPN were recruited into the study. Among the patients, painless DPN was diagnosed by using the current perception threshold test. Sleep quality was assessed using the Pittsburgh Sleep Quality Index questionnaire.

Results

The percentage of painless DPN was significantly higher in the poor sleep quality group than the good sleep quality group (70.0% vs. 35.5%, P<0.001). In the subscale results, stimulus values at 2,000 Hz, hypoesthesia and hyperesthesia were more common in the poor sleep quality group than in the good sleep quality group (45.7% vs. 25.0%, P=0.009; 34.3% vs. 18.4%, P=0.029; 40.0% vs. 19.7%, P=0.007, respectively). The association of painless DPN and poor sleep quality remained significant after adjustment for significant covariates (odds ratio, 3.825; 95% confidence interval, 1.674 to 8.742; P<0.001).

Conclusion

The current study showed that painless DPN was associated with poor sleep quality. Future studies are required to clarify the pathophysiologic causal relationship between painless DPN and sleep quality.

Citations

Citations to this article as recorded by  
  • Deteriorated sleep quality and associate factors in patients with type 2 diabetes mellitus complicated with diabetic peripheral neuropathy
    Lin Fu, Liping Zhong, Xin Liao, Lingrui Wang, Youyi Wang, Xiuquan Shi, Yanna Zhou
    PeerJ.2024; 12: e16789.     CrossRef
  • Sleep impairment: Is it an overlooked burden in painful diabetic peripheral neuropathy? A single-centre, cross-sectional study from south India
    Adlin Lawrence, Himsikhar Khataniar, Sinimol Joseph, Thenmozhi Nagarajan, Soumya Umesh, John Michael Raj A
    Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2022; 16(8): 102568.     CrossRef
  • Sleep: an emerging therapeutic target in diabetes care
    Nishant Raizada, S. V. Madhu
    International Journal of Diabetes in Developing Countries.2021; 41(1): 1.     CrossRef
Complications
Deterioration of Sleep Quality According to Glycemic Status
Myung Haeng Hur, Mi-Kyoung Lee, Kayeon Seong, Jun Hwa Hong
Diabetes Metab J. 2020;44(5):679-686.   Published online April 17, 2020
DOI: https://doi.org/10.4093/dmj.2019.0125
  • 4,815 View
  • 113 Download
  • 4 Web of Science
  • 8 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background

Type 2 diabetes mellitus (T2DM) is a progressive disease with multiple complications. The present study aimed to determine the effects of glycemic status on sleep quality in individuals with T2DM, prediabetes, and normal glucose tolerance (NGT).

Methods

A total of 90 participants were categorized into three groups, T2DM (n=30), prediabetes (n=30), and NGT (n=30). Objective sleep quality was measured with the actigraph wrist-worn device over 3 nights and subjective sleep quality was evaluated with a questionnaire.

Results

The duration of diabetes in the T2DM group was 2.23 years and the glycosylated hemoglobin (HbA1c) levels in the T2DM, prediabetes, and NGT groups were 7.83%, 5.80%, and 5.31%, respectively. Sleep efficiency decreased across the T2DM, prediabetes, and NGT groups (86.25%, 87.99%, and 90.22%, respectively; P=0.047). Additionally, HbA1c levels revealed a significant negative correlation with sleep efficiency (r=−0.348, P=0.001). The sleep quality questionnaire results were similar among the three groups.

Conclusion

Although the participants in the present study were not necessarily conscious of their sleep disturbances, deterioration in sleep quality progressed according to glycemic status.

Citations

Citations to this article as recorded by  
  • Risk factors of non communicable diseases among recently diagnosed diabetic patients in a tertiary care Hospital
    Yusra Amin, Sonia Mushtaq, Rukhsana Farooq
    Indian Journal of Clinical Anatomy and Physiology.2024; 10(4): 205.     CrossRef
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    Asmaa Ali Elsayed Ali
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    Frontiers in Endocrinology.2022;[Epub]     CrossRef
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    Sara AL-Musharaf, Lama AlAjllan, Ghadeer Aljuraiban, Munirah AlSuhaibani, Noura Alafif, Syed Danish Hussain
    Nutrients.2022; 14(14): 2898.     CrossRef
  • The impact of sleep disorders on microvascular complications in patients with type 2 diabetes (SLEEP T2D): the protocol of a cohort study and feasibility randomised control trial
    Christina Antza, Ryan Ottridge, Smitaa Patel, Gemma Slinn, Sarah Tearne, Matthew Nicholls, Brendan Cooper, Asad Ali, Abd A. Tahrani
    Pilot and Feasibility Studies.2021;[Epub]     CrossRef
  • Early Development of Bidirectional Associations between Sleep Disturbance and Diabetes
    Yongin Cho
    Diabetes & Metabolism Journal.2020; 44(5): 668.     CrossRef
Reviews
Obesity and Metabolic Syndrome
Metabolic Consequences of Obstructive Sleep Apnea Especially Pertaining to Diabetes Mellitus and Insulin Sensitivity
Sun Ok Song, Ken He, Radhika R. Narla, Hyun Goo Kang, Han Uk Ryu, Edward J. Boyko
Diabetes Metab J. 2019;43(2):144-155.   Published online April 15, 2019
DOI: https://doi.org/10.4093/dmj.2018.0256
  • 7,060 View
  • 147 Download
  • 43 Web of Science
  • 42 Crossref
AbstractAbstract PDFPubReader   

Obstructive sleep apnea (OSA) and diabetes has been known to be closely related to each other and both diseases impact highly on the public health. There are many evidence of reports that OSA is associated with diabetes with a bidirectional correlation. A possible causal mechanism of OSA to diabetes is intermittent hypoxemia and diabetes to OSA is microvascular complication. However, OSA and diabetes have a high prevalence rate in public and shares the common overlap characteristic and risk factors such as age, obesity, and metabolic syndrome that make it difficult to establish the exact pathophysiologic mechanism between them. In addition, studies demonstrating that treatment of OSA may help prevent diabetes or improve glycemic control have not shown convincing result but have become a great field of interest research. This review outlines the bidirectional correlation between OSA and diabetes and explore the pathophysiologic mechanisms by approaching their basic etiologies.

Citations

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    Nature and Science of Sleep.2024; Volume 16: 217.     CrossRef
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    International Journal of Molecular Sciences.2024; 25(6): 3243.     CrossRef
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    Ruihan Lin, Wenjie Yan, Meng He, Bin Liu, Xiaoli Su, Minhan Yi, Yuan Zhang
    Sleep and Breathing.2024;[Epub]     CrossRef
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    Chonggui Zhu, Shaofang Tang, Jinfeng Xiao, Yang Zhang, Longhao Sun, Jing Zhang, Li Ding, Ming Liu
    Obesity Facts.2023; 16(4): 344.     CrossRef
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Obstructive Sleep Apnea and Abnormal Glucose Metabolism
Nan Hee Kim
Diabetes Metab J. 2012;36(4):268-272.   Published online August 20, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.4.268
  • 3,269 View
  • 36 Download
  • 16 Crossref
AbstractAbstract PDFPubReader   

Obstructive sleep apnea (OSA) is a chronic disorder that is prevalent, especially in subjects with obesity or diabetes. OSA is related to several metabolic abnormalities, including diabetes, insulin resistance, hypertension, and cardiovascular diseases. Although Koreans are less obese than Caucasians, the prevalence of OSA is comparable in both groups. Thus, the impact of OSA on metabolism may be similar. Many epidemiologic and experimental studies have demonstrated that OSA is associated with glucose intolerance and insulin resistance via intermittent hypoxia, sleep fragmentation, and sleep deprivation. The effect of continuous positive airway pressure treatment on glucose metabolism is still controversial. Randomized controlled trials are needed to evaluate the ability of OSA treatment to reduce the risk of diabetes and insulin resistance in subjects without diabetes and to ameliorate glucose control in patients with diabetes.

Citations

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Original Article
Prevalence and Correlates of Disordered Sleep in Southeast Asian Indians with Type 2 Diabetes
Amarabalan Rajendran, Shruthi Parthsarathy, Bubblu Tamilselvan, Krishna G. Seshadri, Mohamed Shuaib
Diabetes Metab J. 2012;36(1):70-76.   Published online February 17, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.1.70
  • 3,745 View
  • 55 Download
  • 29 Crossref
AbstractAbstract PDFPubReader   
Background

Sleep disturbances are common in individuals with diabetes. Patients with diabetes have higher rates of insomnia, excessive daytime sleepiness and increased incidence of restless leg syndrome. The purpose of our study was to investigate the prevalence and determine the predictors of sleep dysfunction in patients with type 2 diabetes in a southeast Asian Indian population.

Methods

We enrolled 120 patients with type 2 diabetes who attended an endocrinology clinic in a tertiary-care hospital. After we collected their demographic data, we recorded their anthropometric measurements. Fasting, postprandial blood glucose values and glycosylated hemoglobin (HbA1c) values were then obtained. Quality of sleep was evaluated in all the patients through the Pittsburgh Sleep Quality Index (PSQI), which is a questionnaire that assesses sleep quality and disturbances over a monthlong period. A Global Sleep Quality score ≥5 discriminates between good and poor sleepers.

Results

The mean global PSQI score was 7.08 (standard deviation, 3.89), which suggested poor sleep quality in this population. Sixty-nine percent of patients had a global PSQI score ≥5, indicating that they were "poor sleepers." The global PSQI score positively correlated with the duration of diabetes and was also independent of other variables such as age, gender, body mass index, HbA1c, or medications.

Conclusion

We found a high prevalence of sleep dysfunction in patients with type 2 diabetes. We also found a significant correlation between duration of diabetes and quality of sleep, independent of other variables. It is important for physicians to address the quality and duration of sleep in patients with type 2 diabetes.

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