The studies performed in this thesis show that type 1 diabetes mellitus is characterized not only by insulin deficiency, but also by insulin resistance. Both hepatic and peripheral insulin... Show moreThe studies performed in this thesis show that type 1 diabetes mellitus is characterized not only by insulin deficiency, but also by insulin resistance. Both hepatic and peripheral insulin sensitivity were decreased in patients with type 1 diabetes mellitus, as well as inhibition of lipolysis. However, insulin resistance is not a fixed pathophysiological condition in type 1 diabetes. We demonstrated that a single night of partial sleep deprivation decreased insulin sensitivity by 14-20% in patients with type 1 diabetes and by 20-25% in healthy controls. These effects of partial sleep restriction could not be explained by a reduction of total slow wave sleep in patients with type 1 diabetes. Sleep duration is a determinant of insulin sensitivity, also in patients with diabetes. In addition, various aspects of diabetes could be linked to increased prevalence of sleep disturbances. Impaired sleep and type 1 diabetes might potentiate each other in some patients, thereby creating a negative vicious circle. Optimizing sleep duration and sleep quality could therefore be considered as a potential therapeutic target to improve metabolic control in patients with type 1 diabetes. Show less
