Sleep and Glucose Intolerance/Diabetes Mellitus
Section snippets
Glucose metabolism and its clinical disorders
Diabetes mellitus is a group of metabolic disorders characterized by chronic hyperglycemia caused by various pathogenetic processes in glucose homeostasis [1], [2]. In health, glucose homeostasis is achieved by regulating glucose production by the liver (gluconeogenesis) and glucose use by insulin-dependent tissues, such as muscle and fat, and non–insulin-dependent tissues, such as the brain [3]. Insulin is secreted by pancreatic β cells, both constitutionally and acutely in response to glucose
Influence of sleep on glucose metabolism
Contrary to most mammals, human sleep is generally consolidated into a single 7- to 9-hour period, leading to an extended period of fasting overnight. Both pancreatic β-cell responsiveness and insulin sensitivity are influenced by sleep. Despite the extended fast during overnight sleep, blood glucose levels remain stable or fall only minimally. By comparison, when individuals are awake and fasting in a recumbent position without any physical activity, glucose levels decrease an average of 10 to
Sleep-disordered breathing and glucose metabolism
Obstructive sleep apnea (OSA) is the most common form of SDB worldwide [55], [56]. A high association between OSA and glucose intolerance/diabetes mellitus would not be unexpected because they share the common risk factor of obesity. Research momentum has focused on the hunt for evidence of independent pathogenetic links between SDB and glucose metabolism disorders. The identification of a causal role would have implications not only on the understanding of disease pathogenesis but also on
Summary
The sleep state itself has modulatory effects on glucose homeostasis. Epidemiologic and experimental studies suggest that sleep loss and sleep disturbances are detrimental to metabolic function and may predispose to obesity or glucose intolerance. Apart from the common risk factor of obesity, increasing data also support that OSA exerts independent adverse effects on glucose intolerance/diabetes mellitus, although definitive evidence is still needed.
Acknowledgments
The authors are grateful to Professor Eve Van Cauter of the University of Chicago for her support with the preparation of this manuscript.
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Consequences of circadian disruption on cardiometabolic health
2015, Sleep Medicine ClinicsCitation Excerpt :Furthermore, poor sleep quality has also been associated with increased risk of incident type 2 diabetes.61 The association between sleep and cardiometabolic disease has been reviewed extensively.63,64 Thus, impairments in sleep could partially mediate the association between shift work or chronotype and cardiometabolic disease.
Obstructive sleep apnea is independently associated with inflammation and insulin resistance, but not with blood pressure, plasma catecholamines, and endothelial function in obese subjects
2015, NutritionCitation Excerpt :However, the exact pathophysiological mechanism responsible for this association remains incompletely understood [22,23]. The common factor of adiposity cannot be ignored, but both theoretical basis and evidence suggest that sleep breathing disorder itself may impair glucose homeostasis [24]. There is evidence that in OSA, the hypoxia in adipose tissue can lead to death of adipocytes with consequent release of free fatty acids, favoring insulin resistance [25].
Sleep apnea-hypopnea syndrome and type 2 diabetes. A reciprocal relationship?
2015, Archivos de BronconeumologiaCitation Excerpt :In addition to studies in the general population, several authors have evaluated the duration and quality of sleep in patients with diabetes.84,85 Most found that poor sleep quality was more prevalent in patients with diabetes,85 and that this negatively affected blood glucose control.84,85 The influence of quality of sleep on glucose tolerance has also been investigated in various longitudinal series.49,82,83,86,87
Sleep quality and its impact on glycaemic control in patients with type 2 diabetes mellitus
2014, International Journal of Nursing SciencesImportance of pre-anesthetic evaluation: Case report of a patient with obstructive sleep apnea
2011, Revista Brasileira de Anestesiologia