Type 1 diabetes mellitus and sleep: implications for glucoregulation

Abstract

The present thesis described the interaction between impaired sleep characteristics and glucose regulation in patients with T1DM and healthy controls. In addition, we described the impact of impaired sleep characteristics on sustained attention in patients with T1DM. From the studies described in this thesis we can conclude that : 1. A single night of partial sleep restriction decreased insulin sensitivity of multiple metabolic pathways in controls. 2. A single night of partial sleep deprivation reduced insulin-mediated peripheral glucose uptake in patients with T1DM. 3. A single night of selective SWS suppression did not induce insulin resistance in healthy controls; reduced sleep duration rather than altered sleep composition is therefore an important determinant of insulin sensitivity in controls. 4. Disturbed sleep characteristics are part of the complex syndrome of patients with longstanding T1DM. 5. No effect of short-term controlled hyperglycemic dysregulation on objective sleep characteristics in patients with T1DM. 6. Diabetes per se is independently associated with impaired sustained attention in patients with T1DM. Optimizing sleep duration could be a therapeutic target to optimize glucoregulation in these patients, since voluntary sleep curtailment is common in this 24-hr modern society.