Sleep Disorders in Type One Diabetic Patients, Relation to Glycemic Control

Abstract

he current study explores the association between sleep disturbances and glycemic control, insulin resistance and diabetic vascular complications among type 1 diabetic adolescent. This case control study was carried out on Sixty adolescents with T1D were compared to 60 matched controls, who were diagnosed and followed up in Diabetes Clinic Ain Shams University Hospital. Diabetes-duration, insulin-therapy, fundus, and the neuropathy disability score were assessed. Fasting lipid profile, fraction-C of glycosylated hemoglobin (HbA1c%) and urinary albumin-excretion were measured with calculation of the insulin sensitivity score (ISS). Overnight polysomnography (PSG) was done with analysis of various sleep parameters. Our study show that ISS was positively correlated with sleep efficiency and negatively correlated with stage 2 sleep and periodic limb movement index (PLMI). HbA1c was positively correlated to sleep onset latency and stage 2 sleep, and negatively correlated to sleep efficiency and rapid eye movement (REM). Diabetic nephropathy was positively correlated to light sleep and negatively correlated to deep sleep. In addition, adolescents with T1D having diabetic neuropathy had significantly longer light sleep and shorter deep sleep with increased arousal index. Sleep efficiency was positively correlated to high-density lipoproteins (HDL) and negatively correlated to low-density lipoproteins (LDL), while REM was negatively correlated to total cholesterol and triglycerides. Arousal index was positively correlated to total cholesterol and negatively correlated to HDL, and the number of awakenings/nights was positively correlated to LDL and triglycerides.