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The Relationship Between Sleep Quality and HbA1c of Patients with Type 2 Diabetes

Year 2021, Volume , Issue 15, 446 - 455, 31.12.2021
https://doi.org/10.38079/igusabder.892777

Abstract

Aim: Sleep disorders are common in patients with type-2 diabetes. This study aims to examine the relationship between sleep quality and sleep quality subdimensions and HbA1c levels of patients with type 2 diabetes.
Method: This correlative and cross-sectional design study was conducted in Istanbul/ Turkey between November 10, 2020, and December 10, 2020. The data collection form created by the researchers and the Pittsburgh Sleep Quality Index (PSQI) were used to collect data.
Result: Of the 186 patients with type 2 diabetes in the study 56.4% smokers. It was determined that the mean total PSQI score of the patients was 14.89±3.69 and 85.4% had low sleep quality (PSQI>5). A positive significant relationship was found between PSQI total score and HbA1c (r:0.245, p:0.042). In addition, a positive relationship was found between HbA1c and the scores of habitual sleep efficiency (r:0.145, p:0.036) and sleep disorder (r:0.223, p:0.032) sub-scale. The total PSQI scores of women were significantly higher (p: 0.042) and sleep duration was shorter (p<0.001) compared to men. It was determined that the sleep quality of non-smokers was better than that of smokers (p:0.017).
Conclusion: A positive relationship was found between impaired sleep quality and HbA1c in patients with type 2 diabetes. It was found out that this relationship was due to habitual sleep efficiency and sleep disorder and that sleep quality was worse in women and smokers. Often overlooked in the follow-up of patients with diabetes, assessment of sleep quality should be part of diabetes care.

References

  • Saeedi P, Petersohn I, Salpea P, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the international diabetes federation diabetes atlas. Diabetes Research and Clinical Practice. 2019;157:107843.
  • Stratton IM, Adler AI, Neil HAW, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. Br Med J. 2000;321(7258):405-412. doi:10.1136/bmj.321.7258.405.
  • Edelman SV, Polonsky WH. Type 2 diabetes in the real world: the elusive nature of glycemic control. Diabetes Care. 2017;40(11):1425-1432. doi:10.2337/dc16-1974.
  • Aschner P, Gagliardino JJ, Ilkova H, et al. Correction to: Persistent poor glycaemic control in individuals with type 2 diabetes in developing countries: 12 years of real-world evidence of the international diabetes management practices study (IDMPS). Diabetologia. 2020;63(5):1088-1089. doi:10.1007/s00125-020-05118-3.
  • Noor SK, Elmadhoun WM, Bushara SO, et al. Glycaemic control in Sudanese individuals with type 2 diabetes: Population based study. Diabetes Metab Syndr Clin Res Rev. 2017;11:S147-S151. doi:10.1016/j.dsx.2016.12.024.
  • Association AD. Facilitating behavior change and well-being to improve health outcomes: Standards of medical care in diabetes-2020. Diabetes Care. 2020;43(Supplement 1):S48-S65. doi:10.2337/dc20-S005.
  • Lee SWH, Ng KY, Chin WK. The impact of sleep amount and sleep quality on glycemic control in type 2 diabetes: A systematic review and meta-analysis. Sleep Med Rev. 2017;31:91-101. doi:10.1016/j.smrv.2016.02.001.
  • Barikani A, Javadi M, Rafiei S. Sleep quality and blood lipid composition among patients with diabetes. Int J Endocrinol Metab. 2019;17(3):e81062. doi:10.5812/ijem.81062.
  • Keskin A, Ünalacak M, Bilge U, et al. Effects of sleep disorders on hemoglobin A1c levels in type 2 diabetic patients. Chin Med J (Engl). 2015;128(24):3292-3297. doi:10.4103/0366-6999.171415.
  • Larcher S, Benhamou PY, Pépin JL, Borel AL. Sleep habits and diabetes. Diabetes Metab. 2015;41(4):263-271. doi:10.1016/j.diabet.2014.12.004.
  • Roenneberg T, Allebrandt KV, Merrow M, Vetter C. Social jetlag and obesity. Curr Biol. 2012;22(10):939-943. doi:10.1016/j.cub.2012.03.038.
  • Kim BK, Kim BS, An SY, et al. Sleep duration and glycemic control in patients with diabetes mellitus: Korea national health and nutrition examination survey 2007-2010. J Korean Med Sci. 2013;28(9):1334. doi:10.3346/jkms.2013.28.9.1334.
  • Akçay BD, Deniz D. Diyabetik hastalarda subjektif uyku kalitesinin glisemi kontrolü ve kronik diyabetik komplikasyonlar ile ilişkisi. Sağlık Bilim Derg. 2019;28(2):62-69. doi:10.34108/eujhs.467884.
  • Akca D, Saritas SC. Relationship between symptoms observed in patients with type 2 diabetes and the sleep quality. Annals of Medical Research. 2019;26(4):579-583. doi:10.5455/annalsmedres.2019.01.011.
  • Dietch JR, Taylor DJ, Sethi K, Kelly K, Bramoweth AD, Roane BM. Psychometric evaluation of the PSQI in U.S. college students. J Clin Sleep Med. 2016;12(8):1121-1129. doi:10.5664/jcsm.6050.
  • Telford O, Diamantidis CJ, Bosworth HB, et al. The relationship between pittsburgh sleep quality index subscales and diabetes control HHS public access. Chronic Illn. 2019;15(3):210-219. doi:10.1177/1742395318759587.
  • Zhu B, Quinn L, Kapella MC, et al. Relationship between sleep disturbance and self-care in adults with type 2 diabetes. Acta Diabetol. 2018;55(9):963-970. doi:10.1007/s00592-018-1181-4.
  • Ağargün MY, Kara HAÖ. Pittsburgh Uyku Kalitesi indeksinin geçerliği ve güvenirliği. Türk Psikiyatr Derg. 1996;7(107):15.
  • Knutson KL, Ryden AM, Mander BA, Van Cauter E. Role of sleep duration and quality in the risk and severity of type 2 diabetes mellitus. Arch Intern Med. 2006;166(16):1768-1774. doi:10.1001/archinte.166.16.1768.
  • Rajendran A, Parthsarathy S, Tamilselvan B, Seshadri KG, Shuaib M. Prevalence and correlates of disordered sleep in Southeast Asian Indians with type 2 diabetes. Diabetes Metab J. 2012;36(1):70-76. doi:10.4093/dmj.2012.36.1.70.
  • Bener A, Al-Hamaq AOAA, Agan AF, Ozturk M, Omer A. Sleeping disturbances and predictor risk factors among type 2 diabetic mellitus patients. Ann Afr Med. 2020;19(4):230-236. doi:10.4103/aam.aam_51_19.
  • Narisawa H, Komada Y, Miwa T, et al. Prevalence, symptomatic features, and factors associated with sleep disturbance/insomnia in Japanese patients with type-2 diabetes. Neuropsychiatr Dis Treat. 2017;13:1873-1880. doi:10.2147/NDT.S134814.
  • Taub LFM, Redeker NS. Sleep disorders, glucose regulation, and type 2 diabetes. Biol Res Nurs. 2008;9(3):231-243. doi:10.1177/1099800407311016.
  • Barone MTU, Menna-Barreto L. Diabetes and sleep: a complex cause-and-effect relationship. Elsevier. doi:10.1016/j.diabres.2010.07.011.
  • Grandner MA, Seixas A, Shetty S, Shenoy S. Sleep duration and diabetes risk: population trends and potential mechanisms. Curr Diab Rep. 2016;16(11):106-119. doi:10.1007/s11892-016-0805-8.
  • Cappuccio FP, Miller MA. Sleep and cardio-metabolic disease. Curr Cardiol Rep. 2017;19(11):110-118. doi:10.1007/s11886-017-0916-0.
  • Pengo MF, Won CH, Bourjeily G. Sleep in women across the life span. Chest. 2018;154(1):196-206. doi:10.1016/j.chest.2018.04.005.
  • Alnaji A, Law GR, Scott EM. The role of sleep duration in diabetes and glucose control. In: Proceedings of the Nutrition Society. Vol 75. Cambridge University Press; 2016:512-520. doi:10.1017/S002966511600063X.
  • Xu C, Zhang P, Xiang Q, et al. Relationship between subjective sleep disturbances and glycaemia in Chinese adults with type 2 diabetes: Findings from a 1.5-year follow-up study. Sci Rep. 2019;9(1):14276-14284. doi:10.1038/s41598-019-50814-9.
  • Purani H, Friedrichsen S, Allen AM. Sleep quality in cigarette smokers: Associations with smoking-related outcomes and exercise. Addict Behav. 2019;90:71-76. doi:10.1016/j.addbeh.2018.10.023.
  • Sujarwoto S. Sleep Disturbance in Indonesia: How much does smoking contribute? Behav Sleep Med. 2020;18(6):760-773. doi:10.1080/15402002.2019.1682584.
  • Peters EN, Fucito LM, Novosad C, Toll BA, O’Malley SS. Effect of night smoking, sleep disturbance, and their co-occurrence on smoking outcomes. Psychol Addict Behav. 2011;25(2):312-319. doi:10.1037/a0023128.
  • Karamus NF. Sigara içen üniversite öğrencilerinin fiziksel aktivite düzeyi, uyku kalitesi ve yaşam kalitesinin değerlendirilmesi. [yüksek lisans tezi]. İstanbul, Türkiye: Bezmialem Üniversitesi Sağlık Bilimleri Enstitüsü; 2019.

Tip 2 Diyabetli Hastaların Uyku Kaliteleri ile HbA1c Düzeyleri Arasındaki İlişki

Year 2021, Volume , Issue 15, 446 - 455, 31.12.2021
https://doi.org/10.38079/igusabder.892777

Abstract

Amaç: Tip 2 diyabetli hastalarda uyku bozuklukları yaygındır. Bu çalışmanın amacı tip 2 diyabetli hastaların uyku kalitesi ve uyku kalitesinin alt boyutları ile HbA1c düzeyleri arasındaki ilişkiyi incelemektir.
Yöntem: Bu korelatif ve kesitsel tasarım tipindeki çalışma 10 Kasım 2020-10 Aralık 2020 tarihleri arasında İstanbul'da gerçekleştirilmiştir. Veriler, araştırmacılar tarafından oluşturulan veri toplama formu ve Pittsburgh Uyku Kalitesi İndeksi (PUKİ) ile toplanmıştır.
Bulgular: Çalışmaya katılan 186 tip 2 diyabetli hastanın %56.4’ü sigara kullanmaktadır. Hastaların PUKİ toplam puan ortalaması 14.89±3.69 olup %85.4’ünün düşük uyku kalitesine (PUKİ >5) sahip olduğu belirlenmiştir. PUKİ toplam puanı ve HbA1c arasında pozitif yönde anlamlı bir ilişki saptanmıştır (r: 0.245, p: 0.042). Ayrıca alışılmış uyku etkinliği (r: -0.145, p: 0.036) ve uyku bozukluğu (r: 0.223, p: 0.032) alt boyutları puanları ile HbA1c arasında da pozitif yönde ilişki saptanmıştır. Kadınların PUKİ toplam puanları erkeklerden anlamlı olarak daha yüksektir (p: 0.042) ve uyku süreleri daha kısadır p<0.001). Sigara kullanmayan kişilerin uyku kalitelerinin, kullanan kişilere göre daha iyi düzeyde olduğu belirlenmiştir (p:0.017).
Sonuç: Tip 2 diyabetli hastalarda bozulmuş uyku kalitesi ile HbA1c arasında pozitif yönde bir ilişki bulunmuştur. Bu ilişki alışılmış uyku etkinliği ve uyku bozukluğu tarafından yönlendirilmiştir, Kadınlar ve sigara içenlerde uyku kalitesinin daha kötü olduğu saptanmıştır. Diyabet hastalarının takibinde sıklıkla gözden kaçan uyku kalitesi değerlendirilmesi diyabet yönetiminin bir parçası olmalıdır.

References

  • Saeedi P, Petersohn I, Salpea P, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the international diabetes federation diabetes atlas. Diabetes Research and Clinical Practice. 2019;157:107843.
  • Stratton IM, Adler AI, Neil HAW, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. Br Med J. 2000;321(7258):405-412. doi:10.1136/bmj.321.7258.405.
  • Edelman SV, Polonsky WH. Type 2 diabetes in the real world: the elusive nature of glycemic control. Diabetes Care. 2017;40(11):1425-1432. doi:10.2337/dc16-1974.
  • Aschner P, Gagliardino JJ, Ilkova H, et al. Correction to: Persistent poor glycaemic control in individuals with type 2 diabetes in developing countries: 12 years of real-world evidence of the international diabetes management practices study (IDMPS). Diabetologia. 2020;63(5):1088-1089. doi:10.1007/s00125-020-05118-3.
  • Noor SK, Elmadhoun WM, Bushara SO, et al. Glycaemic control in Sudanese individuals with type 2 diabetes: Population based study. Diabetes Metab Syndr Clin Res Rev. 2017;11:S147-S151. doi:10.1016/j.dsx.2016.12.024.
  • Association AD. Facilitating behavior change and well-being to improve health outcomes: Standards of medical care in diabetes-2020. Diabetes Care. 2020;43(Supplement 1):S48-S65. doi:10.2337/dc20-S005.
  • Lee SWH, Ng KY, Chin WK. The impact of sleep amount and sleep quality on glycemic control in type 2 diabetes: A systematic review and meta-analysis. Sleep Med Rev. 2017;31:91-101. doi:10.1016/j.smrv.2016.02.001.
  • Barikani A, Javadi M, Rafiei S. Sleep quality and blood lipid composition among patients with diabetes. Int J Endocrinol Metab. 2019;17(3):e81062. doi:10.5812/ijem.81062.
  • Keskin A, Ünalacak M, Bilge U, et al. Effects of sleep disorders on hemoglobin A1c levels in type 2 diabetic patients. Chin Med J (Engl). 2015;128(24):3292-3297. doi:10.4103/0366-6999.171415.
  • Larcher S, Benhamou PY, Pépin JL, Borel AL. Sleep habits and diabetes. Diabetes Metab. 2015;41(4):263-271. doi:10.1016/j.diabet.2014.12.004.
  • Roenneberg T, Allebrandt KV, Merrow M, Vetter C. Social jetlag and obesity. Curr Biol. 2012;22(10):939-943. doi:10.1016/j.cub.2012.03.038.
  • Kim BK, Kim BS, An SY, et al. Sleep duration and glycemic control in patients with diabetes mellitus: Korea national health and nutrition examination survey 2007-2010. J Korean Med Sci. 2013;28(9):1334. doi:10.3346/jkms.2013.28.9.1334.
  • Akçay BD, Deniz D. Diyabetik hastalarda subjektif uyku kalitesinin glisemi kontrolü ve kronik diyabetik komplikasyonlar ile ilişkisi. Sağlık Bilim Derg. 2019;28(2):62-69. doi:10.34108/eujhs.467884.
  • Akca D, Saritas SC. Relationship between symptoms observed in patients with type 2 diabetes and the sleep quality. Annals of Medical Research. 2019;26(4):579-583. doi:10.5455/annalsmedres.2019.01.011.
  • Dietch JR, Taylor DJ, Sethi K, Kelly K, Bramoweth AD, Roane BM. Psychometric evaluation of the PSQI in U.S. college students. J Clin Sleep Med. 2016;12(8):1121-1129. doi:10.5664/jcsm.6050.
  • Telford O, Diamantidis CJ, Bosworth HB, et al. The relationship between pittsburgh sleep quality index subscales and diabetes control HHS public access. Chronic Illn. 2019;15(3):210-219. doi:10.1177/1742395318759587.
  • Zhu B, Quinn L, Kapella MC, et al. Relationship between sleep disturbance and self-care in adults with type 2 diabetes. Acta Diabetol. 2018;55(9):963-970. doi:10.1007/s00592-018-1181-4.
  • Ağargün MY, Kara HAÖ. Pittsburgh Uyku Kalitesi indeksinin geçerliği ve güvenirliği. Türk Psikiyatr Derg. 1996;7(107):15.
  • Knutson KL, Ryden AM, Mander BA, Van Cauter E. Role of sleep duration and quality in the risk and severity of type 2 diabetes mellitus. Arch Intern Med. 2006;166(16):1768-1774. doi:10.1001/archinte.166.16.1768.
  • Rajendran A, Parthsarathy S, Tamilselvan B, Seshadri KG, Shuaib M. Prevalence and correlates of disordered sleep in Southeast Asian Indians with type 2 diabetes. Diabetes Metab J. 2012;36(1):70-76. doi:10.4093/dmj.2012.36.1.70.
  • Bener A, Al-Hamaq AOAA, Agan AF, Ozturk M, Omer A. Sleeping disturbances and predictor risk factors among type 2 diabetic mellitus patients. Ann Afr Med. 2020;19(4):230-236. doi:10.4103/aam.aam_51_19.
  • Narisawa H, Komada Y, Miwa T, et al. Prevalence, symptomatic features, and factors associated with sleep disturbance/insomnia in Japanese patients with type-2 diabetes. Neuropsychiatr Dis Treat. 2017;13:1873-1880. doi:10.2147/NDT.S134814.
  • Taub LFM, Redeker NS. Sleep disorders, glucose regulation, and type 2 diabetes. Biol Res Nurs. 2008;9(3):231-243. doi:10.1177/1099800407311016.
  • Barone MTU, Menna-Barreto L. Diabetes and sleep: a complex cause-and-effect relationship. Elsevier. doi:10.1016/j.diabres.2010.07.011.
  • Grandner MA, Seixas A, Shetty S, Shenoy S. Sleep duration and diabetes risk: population trends and potential mechanisms. Curr Diab Rep. 2016;16(11):106-119. doi:10.1007/s11892-016-0805-8.
  • Cappuccio FP, Miller MA. Sleep and cardio-metabolic disease. Curr Cardiol Rep. 2017;19(11):110-118. doi:10.1007/s11886-017-0916-0.
  • Pengo MF, Won CH, Bourjeily G. Sleep in women across the life span. Chest. 2018;154(1):196-206. doi:10.1016/j.chest.2018.04.005.
  • Alnaji A, Law GR, Scott EM. The role of sleep duration in diabetes and glucose control. In: Proceedings of the Nutrition Society. Vol 75. Cambridge University Press; 2016:512-520. doi:10.1017/S002966511600063X.
  • Xu C, Zhang P, Xiang Q, et al. Relationship between subjective sleep disturbances and glycaemia in Chinese adults with type 2 diabetes: Findings from a 1.5-year follow-up study. Sci Rep. 2019;9(1):14276-14284. doi:10.1038/s41598-019-50814-9.
  • Purani H, Friedrichsen S, Allen AM. Sleep quality in cigarette smokers: Associations with smoking-related outcomes and exercise. Addict Behav. 2019;90:71-76. doi:10.1016/j.addbeh.2018.10.023.
  • Sujarwoto S. Sleep Disturbance in Indonesia: How much does smoking contribute? Behav Sleep Med. 2020;18(6):760-773. doi:10.1080/15402002.2019.1682584.
  • Peters EN, Fucito LM, Novosad C, Toll BA, O’Malley SS. Effect of night smoking, sleep disturbance, and their co-occurrence on smoking outcomes. Psychol Addict Behav. 2011;25(2):312-319. doi:10.1037/a0023128.
  • Karamus NF. Sigara içen üniversite öğrencilerinin fiziksel aktivite düzeyi, uyku kalitesi ve yaşam kalitesinin değerlendirilmesi. [yüksek lisans tezi]. İstanbul, Türkiye: Bezmialem Üniversitesi Sağlık Bilimleri Enstitüsü; 2019.

Details

Primary Language English
Subjects Medicine
Journal Section Articles
Authors

Elif YILDIRIM AYAZ (Primary Author)
İSTANBUL SULTAN ABDÜLHAMİD HAN SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ
0000-0002-2404-8784
Türkiye


Berna DİNCER
ISTANBUL MEDENIYET UNIVERSITY
0000-0001-7284-7495
Türkiye

Publication Date December 31, 2021
Published in Issue Year 2021, Volume , Issue 15

Cite

Bibtex @research article { igusabder892777, journal = {İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi}, issn = {2536-4499}, eissn = {2602-2605}, address = {İstanbul Gelişim Üniversitesi Sağlık Bilimleri Yüksekokulu - Cihangir Mah. Şehit Jandarma Komando Er Hakan Öner Sk. No: 1 Avcılar / İstanbul / Türkiye}, publisher = {İstanbul Gelisim University}, year = {2021}, volume = {}, pages = {446 - 455}, doi = {10.38079/igusabder.892777}, title = {The Relationship Between Sleep Quality and HbA1c of Patients with Type 2 Diabetes}, key = {cite}, author = {Yıldırım Ayaz, Elif and Dincer, Berna} }
APA Yıldırım Ayaz, E. & Dincer, B. (2021). The Relationship Between Sleep Quality and HbA1c of Patients with Type 2 Diabetes . İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi , (15) , 446-455 . DOI: 10.38079/igusabder.892777
MLA Yıldırım Ayaz, E. , Dincer, B. "The Relationship Between Sleep Quality and HbA1c of Patients with Type 2 Diabetes" . İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi (2021 ): 446-455 <https://dergipark.org.tr/en/pub/igusabder/issue/66537/892777>
Chicago Yıldırım Ayaz, E. , Dincer, B. "The Relationship Between Sleep Quality and HbA1c of Patients with Type 2 Diabetes". İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi (2021 ): 446-455
RIS TY - JOUR T1 - The Relationship Between Sleep Quality and HbA1c of Patients with Type 2 Diabetes AU - Elif Yıldırım Ayaz , Berna Dincer Y1 - 2021 PY - 2021 N1 - doi: 10.38079/igusabder.892777 DO - 10.38079/igusabder.892777 T2 - İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi JF - Journal JO - JOR SP - 446 EP - 455 VL - IS - 15 SN - 2536-4499-2602-2605 M3 - doi: 10.38079/igusabder.892777 UR - https://doi.org/10.38079/igusabder.892777 Y2 - 2021 ER -
EndNote %0 Istanbul Gelisim University Journal of Health Sciences The Relationship Between Sleep Quality and HbA1c of Patients with Type 2 Diabetes %A Elif Yıldırım Ayaz , Berna Dincer %T The Relationship Between Sleep Quality and HbA1c of Patients with Type 2 Diabetes %D 2021 %J İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi %P 2536-4499-2602-2605 %V %N 15 %R doi: 10.38079/igusabder.892777 %U 10.38079/igusabder.892777
ISNAD Yıldırım Ayaz, Elif , Dincer, Berna . "The Relationship Between Sleep Quality and HbA1c of Patients with Type 2 Diabetes". İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi / 15 (December 2021): 446-455 . https://doi.org/10.38079/igusabder.892777
AMA Yıldırım Ayaz E. , Dincer B. The Relationship Between Sleep Quality and HbA1c of Patients with Type 2 Diabetes. IGUSABDER. 2021; (15): 446-455.
Vancouver Yıldırım Ayaz E. , Dincer B. The Relationship Between Sleep Quality and HbA1c of Patients with Type 2 Diabetes. İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi. 2021; (15): 446-455.
IEEE E. Yıldırım Ayaz and B. Dincer , "The Relationship Between Sleep Quality and HbA1c of Patients with Type 2 Diabetes", İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi, no. 15, pp. 446-455, Dec. 2021, doi:10.38079/igusabder.892777

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