New research presented at the Annual Meeting of the European Association for the Study of Diabetes (EASD) in Madrid reveals that people recently diagnosed with diabetes who either sleep too little or too much are more likely to develop damage to their small blood vessels, a condition known as microvascular disease.
This could lead to more severe health problems. The study was conducted by Mette Johansen and Thomas Olesen from the Steno Diabetes Center Odense at Odense University Hospital in Denmark, along with their colleagues.
Microvascular complications, like retinopathy (eye damage) and nephropathy (kidney damage), are significant contributors to the health issues associated with type 2 diabetes (T2D).
Previous research suggests that how long people sleep might affect their risk of developing these complications. This study aimed to understand the link between sleep duration and the presence of microvascular disease in people newly diagnosed with T2D.
The researchers used data from a study called the Specialist Supervised Individualized Multifactorial Treatment of New Clinically Diagnosed Type 2 Diabetes in General Practice (IDA), which is part of a larger Danish research project on type 2 diabetes.
Participants wore Axivity AX3 accelerometers for 10 days to measure their sleep duration at night. The sleep durations were classified into three groups: short (less than 7 hours), optimal (7 to less than 9 hours), and long (9 hours or more).
Microvascular disease was defined based on either a urine albumin/creatinine ratio (UACR) of 30 mg/g or higher, or the presence of diabetic retinopathy (DR), determined through eye exams.
The researchers used computer modeling to compare the different sleep duration groups, adjusting for factors such as age, sex, body mass index (BMI), blood pressure, smoking habits, blood sugar control (measured by glycated hemoglobin or HbA1c), duration of diabetes, and use of blood pressure medication.
A total of 396 participants had valid sleep duration measurements, UACR measurements, and eye exams. The median age of the participants was 62 years, with an average diabetes duration of 3.5 years, and 44% were women.
Most of the participants were overweight, with a median BMI of 31, and 68% were taking blood pressure medication.
The distribution of sleep duration among the participants was 12% (49 people) with short sleep, 60% (238 people) with optimal sleep, and 28% (109 people) with long sleep.
The prevalence of microvascular damage was 38% in the short sleep group, 18% in the optimal sleep group, and 31% in the long sleep group.
Short sleep was linked to a 2.6 times higher risk of microvascular disease compared to optimal sleep. Similarly, long sleep was linked to a 2.3 times higher risk of microvascular disease compared to optimal sleep.
The study also found that age influenced the relationship between short sleep and microvascular disease. For participants younger than 62 years, short sleep only increased the risk of microvascular damage by 23% compared to optimal sleep.
However, for participants aged 62 years and older, short sleep was associated with a 5.7 times higher risk of microvascular damage compared to optimal sleep. The effect of age on the relationship between long sleep and microvascular disease was not statistically significant.
The researchers concluded that both short and long sleep durations are linked to a higher prevalence of microvascular disease in newly diagnosed T2D patients compared to optimal sleep duration. They noted that older individuals seem to be more vulnerable to the effects of short sleep.
They suggested that lifestyle changes for patients with type 2 diabetes might include sleep interventions. However, they emphasized the need for more research to determine the role of sleep duration and quality in these patients.
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