Obese Adolescents, Lack of Sleep, and Type 2 Diabetes

How Does Sleep Deprivation Affect Glucose and Insulin Homeostasis?

Obese young girl, up late and watching televisionHere’s what’s known: lack of sleep increases the risk of developing type 2 diabetes in adults.  Researchers started from there and took on this question:  does sleep deprivation and/or altered sleep architecture affect glycemic regulation or insulin sensitivity/secretion?  They hypothesized that in obese adolescents, sleep deprivation and/or altered sleep architecture would be associated with changed glucose and insulin homeostasis.

The study will be published in the November 2011 issue of Diabetes Care; an online version of it appeared in September 2011.  It’s called “Sleep Architecture and Glucose and Insulin Homeostasis in Obese Adolescents.”

This is a cross-sectional observational study.  It involved 62 obese adolescents, and it was done at the Clinical and Translation Research Center and Sleep Laboratory.

Subjects had:

  • an oral glucose tolerance test (OGTT)
  • anthropometric measurements
  • overnight polysomnography
  • frequently-sampled intravenous glucose tolerance test (FSIGT)

Additionally, researchers obtained hemoglobin A1c levels (A1c) and serial insulin and glucose levels.  They calculated indices of insulin sensitivity and secretion, and they assessed sleep architecture.

Adjusting for confounding variables, the researchers performed correlation and regression analyses; this was to see the association of total sleep and sleep stages with the measures of glucose and insulin homeostasis.

The study discovered a significant U-shaped (quadratic) association between sleep duration and A1c; there was also a significant U-shaped association between sleep duration and serial glucose levels on OGTT.

Positive associations were seen between slow-wave sleep duration (N3) and insulin secretory measures.  This was independent of degree of obesity, pubertal stage, gender, and obstructive sleep apnea measures.

It was seen that both insufficient and excessive sleep were associated with short-term and long-term hyperglycemia in obese adolescents.  Decreased N3 is associated with decreased insulin secretion.  It is possible that these two results are related:  reduced insulin secretory capacity could lead to hyperglycemia.

The authors speculate that optimizing sleep may stave off the development of type 2 diabetes in adolescents who are obese.

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