Using sleep to treat type 2 diabetes: a dream come true?

Therapy Breakthroughs 12. sep 2017 2 min Associate Professor Christian Benedict Written by Morten Busch

Type 2 diabetes is mainly driven by poor lifestyle habits, including physical inactivity and unhealthy food choices. Lifestyle interventions to improve dietary habits and increase exercise have been proven to be promising in treating type 2 diabetes. New research shows that easing sleep problems could also help to improve type 2 diabetes.

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Recent studies have shown that people with untreated insomnia and obstructive sleep apnoea exhibit a higher risk of developing a variety of metabolic diseases, including type 2 diabetes. Worryingly, experimental studies have further demonstrated that just a few nights of either little or low-quality sleep are sufficient to impair glucose metabolism among healthy people.

With this in mind, Christian Benedict from Uppsala University and his research team thoroughly reviewed recent research to investigate how aiding sleep influences glucose metabolism among people with type 2 diabetes, now published in the prestigious The Lancet Diabetes & Endocrinology.

“Both epidemiological and experimental evidence indicates that improving sleep may help reduce the risk of developing type 2 diabetes. Encouragingly, our analysis also provided strong support for the hypothesis that some interventions to improve sleep could enhance the management of people with type 2 diabetes,” explains Christian Benedict, Professor, Department of Neuroscience, Uppsala University

Mask-based therapy

Insomnia mainly comprises difficulty in falling and staying asleep. Obstructive sleep apnoea is a condition in which people either partly or fully stop breathing for more than 10 seconds while asleep, several times per hour, night after night.

“Whether aiding sleep could help to improve glucose regulation among people who have already been diagnosed with type 2 diabetes has not yet been systematically investigated, but our literature analysis revealed that growing evidence suggests that these people very often have sleep problems.”

Both insomnia and obstructive sleep apnoea have been linked to high blood pressure, increased activity of stress systems and systemic insulin resistance, all of which can exacerbate the pathophysiology of type 2 diabetes. Thus, people who have both type 2 diabetes and sleep problems are likely to be a high-risk group for disease progression and might have generalized resistance to typical treatments for people with type 2 diabetes.

“For instance, continuous positive airway pressure therapy, a mask-based therapy to prevent people from stopping breathing while asleep, has been shown to improve glucose metabolism among people with type 2 diabetes. However, in this context, it appears to be essential that this therapy be used during the entire sleep period and not just restricted to early sleep.”

Doctors lack knowledge on sleep

Several drugs often used to ease insomnia symptoms, such as melatonin, can lead to an undesirable rise in blood glucose, highlighting that they should be cautiously prescribed. The absolutely safest way of improving sleep and glucose metabolism is related to changing behaviour.

“Exercise and diet are key factors in treating people with sleep disorders. Both regular aerobic training and dietary interventions, such as calorie restriction, improve not only glucose metabolism but also sleep among people with type 2 diabetes. A multifaceted lifestyle intervention targeting exercise, diet and sleep could therefore be the most effective way of treating these people.”

Although more thorough studies with greater sample size and longer duration are needed, Christian Benedict is convinced that aiding sleep has promising therapeutic potential in treating people with metabolic diseases, including type 2 diabetes.

“Many diabetic specialists pay little or no attention to their patients’ sleep, although compelling evidence indicates that sleep problems may aggravate their metabolic conditions. More strongly emphasizing the role of sleep in metabolic disorders in educating future physicians might help to solve this problem.”

Aiding sleep in type 2 diabetes: therapeutic considerations” has been published in The Lancet Diabetes & Endocrinology. In 2014, the Novo Nordisk Foundation awarded a grant to Christian Benedict for the project The Role of the Fat Mass and Obesity Gene for Sleep Loss–related Health Consequences in Humans.

Our research aims at unravelling molecular and behavioral mechanisms through which sleep loss or misaligned sleep contribute to the development and ma...

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