7 January 2014 Diabetes Diary: Not Enough Sleep Could Be Impairing Both Your Weight and Diabetes Control!

I have noticed a familiar pattern in many patients - poor sleep that goes hand in hand with poor blood glucose control and difficulty losing or controlling weight. What's going on? Can inadequate sleep interfere with one's best efforts to control diabetes and weight? Apparently, yes!

Sleep & Blood Glucose Control

There are sleep studies that show a relationship between short sleep hours (e.g. 4 - 5 hrs sleep/day) and:

  • Impaired glucose control: blood glucose level too high
  • Impaired insulin production: the pancreas produces less insulin in response to a given blood glucose level
  • Reduced insulin sensitivity: the insulin on board is not as effective at reducing blood glucose levels

Different studies use varying days of short sleep challenges but most use between 2 - 7 days for testing. So these metabolic changes are taking place rapidly - in as little as 2 days rather than taking weeks, months, or years to develop. Some studies compare short sleep vs. what is considered a standard night sleep (8-8.5hrs) or they compare short sleep to recovery sleep (sleeping 10-12 hrs).

The good news is that when these sleep study participants are followed during recovery after sleep debt, the measurements of blood glucose, insulin production, and insulin sensitivity improve.

For those of you who experience inadequate sleep, how frequently do you allow yourself to sleep until you wake up, without using an alarm clock? If you routinely function on a sleep debt, you could be increasing your risk for diabetes. If you already have diabetes, sleep debt could be making it more difficult to manage your diabetes.

Sleep & Appetite

Sleep studies also show a relationship between sleep, appetite hormone levels, hunger, and caloric intake. This is important to everyone since increased body weight is a risk for prediabetes, Type 2 diabetes, gestational diabetes, and if you already have Type 2 diabetes, could make blood glucose control difficult.

There are two important hormones related to eating & appetite:

Leptin: acts like an appetite suppressant. Level increases after eating and is associated with satiety after a meal.

Ghrelin: acts like an appetite stimulant. Level decreases after eating a meal.

Lack of adequate sleep can cause leptin levels to decrease (less appetite suppression) and ghrelin levels to increase (more appetite stimulation). This is a problem for folks with diabetes as well as for those trying to lose weight. And to make matters even more challenging, it appears that the increased appetite with inadequate sleep could increase one's craving for high calories-dense carb foods such as sweets and salty chips. This is a double-whammy for folks with diabetes - both in terms of controlling blood glucose levels and weight.

Getting More Sleep

What can you do right now to improve your sleep?

Scheduling. For many of you, it is simply a matter of scheduling more time to sleep. That could mean getting to bed earlier or sleeping later. Or perhaps it is time to reconsider a job that requires working a night shift.

Sleep Disorder. If you sleep 8-9 hrs and still have daytime sleepiness, wake up feeling groggy and tired with headaches, snore, then share these symptoms with your doctor. You might have Obstructive Sleep Apnea - a condition where you do not get enough oxygen while sleeping. This condition can be effectively treated, depending upon its cause.

Poor Sleep. If you are under a lot of stress and you are sleeping poorly (trouble getting to sleep or staying asleep), then share this with your doctor. You might benefit from a more intensive exercise program, seeing a therapist, and/or a medication that can help reduce anxiety, depression, or improve sleep.

Even if you cannot correct poor sleep right away, tracking intake and exercise will help you get a handle on calories to control your weight as well as carbs to control blood glucose. Tip: Consider fresh fruit as a healthier carb choice vs. sweets when your carb craving is on overdrive, and include protein foods in meals and snacks to help support satiety.

For more information on sleep, The National Sleep Foundation has a helpful website. Harvard's “Healthy Sleep” website is also helpful.

Basic information on sleep studies was obtained from the American Diabetes Association's 60th Annual Advanced Postgraduate Course Webcasts. Presentation Title: Sleep Deficiency and Diabetes. Presenter: Kristen L. Knutson, PhD. Accessed online on 1/4/14 at http://nethealthllc.com/ADAWEBCAST60/.

Katherine Isacks, MPS, RD, CDE
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Disclaimer: The information provided here does not constitute medical advice. If you are seeking medical advice, please visit your healthcare provider or medical professional.


Diabetes/Blood glucose Other Health Issues/Sleep

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