Not enough sleep linked to type 2 diabetes risk

Global diabetes prevalence has reached alarming proportions. According to the Institute for Health Metrics and Evaluation (IHME), a global health research organization, more than half a billion people worldwide were living with diabetes in 2023, and that number is expected to more than double to 1.3 billion by 2050.

The latest and most comprehensive analysis of global diabetes by IHME, which is based at the University of Washington in the United States, found that with a 6.1 percent prevalence rate, diabetes is one of the top 10 leading causes of death and disability. In addition, diabetes and kidney diseases related to diabetes account for over 2 million deaths every year.

Around 96 percent of diabetic cases around the world were attributed to type2 diabetes (T2D), which is caused by a buildup of glucose levels due to either the body not reacting to insulin effectively, or because it is unable to produce enough insulin. Insulin is an essential hormone produced by the pancreas, which helps regulate blood sugar levels. For people living with diabetes, access to affordable treatment, including insulin, is critical to their survival.

Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin by itself. Type 1 diabetes cannot currently be prevented. Effective approaches are available to prevent type 2 diabetes and to prevent the complications and premature death that can result from all types of diabetes.

Treatment for type 2 diabetes usually involves careful monitoring of blood sugar levels and medications. Additionally, diet, weight management, quitting smoking, and exercise are also recommended as part of a broader approach to treating the condition. If left untreated, diabetes could over time lead to serious damage to the heart, blood vessels, eyes, kidneys and nerves.

Over a dozen risk factors have been identified in leading to diabetes, including obesity, lack of exercise, and a poor diet, as well as genetics, age, race and ethnicity, as well as logistical, social, and financial barriers within a country’s structural system, especially in low- and middle-income countries, which have led to an increase in diabetes prevalence in these countries.

Adding to the list of risk factors, a new study found that people who sleep less than six hours a night are at considerably higher risk for type 2 diabetes than those who sleep seven to eight hours a night. Even people who follow a healthy dietary regimen but have habitual short sleep patterns carry that risk, which implies that sleep is crucial to T2D prevention.

The study followed nearly 250,000 adults in the UK between May and September of 2023. The mean age of the participants was 55.9 years old, and the group had varying dietary habits ranging from red meat, processed meat, fruits, vegetables, and fish, resulting in a healthy diet score ranging from 0 (unhealthiest) to 5 (healthiest).

Dysfunctional sleep patterns have wide-ranging health consequences and the causes for it are categorized into long-term and short-term, each with different implications for health. Short-term disturbances caused by factors like stress, travel, pregnancy, lead to temporary discomfort or fatigue have less impact on long-term health.

Long-term disturbances, such as insomnia, sleep apnea, and restless leg syndrome, which result in prolonged periods of inadequate or poor-quality sleep have been linked to various health problems, including an increased risk of developing type 2 diabetes. While disrupted sleep can occur at various points in life, for a multiplicity of reasons, the main focus of the new study was on long-term short sleep duration. The study found that the extremes — not enough sleep (less than 6 hours) or an excess of sleep (more than 9 hours) — contribute to a higher risk of T2D.

Chronic short sleep duration can lead to insulin resistance, impaired glucose tolerance, increased levels of HbA1c (glycated hemoglobin). A blood HbA1c test is used to diagnose type 2 diabetes, as well as to monitor blood glucose control in people with diabetes. Increased levels of HbA1c indicates poor long-term glucose control. Conversely, long sleep duration may signal underlying health issues such as depression, sleep disorders, or chronic diseases, which are also risk factors for T2D.

Our body runs on circadian rhythms that respond to light changes in our environment, and help regulate the functioning of all our organs, tissues and glands. When circadian patterns are disrupted our sleep patterns are affected, and the body becomes more vulnerable to inflammation, stress, impaired glucose metabolism, and imbalances to appetite hormones.

In addition to its impact on insulin and glucose metabolism, inadequate sleep can also affect the body’s regulation of two other hormones called ghrelin and leptin that affect our appetites. Ghrelin, which increases appetite, increases when we lack sleep. The increase in appetite leads to more eating including sugary or sweet foods that exacerbate blood glucose levels. Insufficient sleep also leads to decrease in leptin, a hormone produced by adipose tissue and responsible for suppressing appetite. Less leptin, or a lack of leptin receptors leads to uncontrolled hunger, resulting in obesity, a major risk factor for T2D.

Sleep problems are also an issue for people with no other diabetes risk factors. Studies on mostly young, healthy adults without obesity or any diabetes risk factors have shown a consistent association with decreased insulin sensitivity in the range of 25 to 30 percent in as little as 4 to 5 days of insufficient sleep among these participants. Subsequent cohort studies showed that after controlling for factors such as age, body mass index, being sedentary, and family history, and excluding people who have diabetes, participants who slept for short durations were about 40 percent more likely than those with 7 to 8 hours of sleep to develop diabetes.

While brief naps can result in better energy and cognitive function during the day, they do not make up for chronic short sleep patterns. Our bodies need a long stretch of sleep to do the deep repair work it needs to function properly. If you are in a phase of life where you are temporarily unable to get adequate sleep, naps can help to better support your energy levels,mood and brain health. But you cannot nap your way to better health. Only regular, consistent, and quality sleep every night can do that.

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