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Insomnia increases risk for type 2 diabetes
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Taiwanese adults diagnosed with insomnia have a 16% greater risk for developing type 2 diabetes over 9 years compared with those reporting adequate sleep, and the risk increases with insomnia duration, study data show.
“Studies have indicated that sleep plays [an] important role in the regulation of neuroendocrine function and metabolism in adults,” Chia-Ling Lin, MS, RN, a doctoral student and instructor at the School of Nursing at National Taiwan University College of Medicine in Taipei, Taiwan, and colleagues wrote. “Although insomnia has been associated with type 2 diabetes mellitus, whether this association holds true both for chronic and intermittent insomnia remains unknown, and the possibility of a time-dependent cumulative effect between the risk of type 2 diabetes and insomnia remains scarce.”
Lin and colleagues analyzed data from 28,390 adults without diabetes at baseline newly diagnosed with insomnia between January 2001 and December 2004. They used data from 1 million randomly selected patients from Taiwan’s National Health Insurance Database, as well as 57,413 sex- and age-matched controls without insomnia over the same period. Patients were stratified by age, comorbidities and urbanization level. Researchers followed both groups until onset of type 2 diabetes or December 2010 (mean follow-up time, 6 years) and used Cox proportional hazard regression models to assess the influence of insomnia on type 2 diabetes risk.
Over follow-up, type 2 diabetes incidence was higher in the insomnia group than among controls (34.7 per 1,000 person-years vs. 24.3 per 1,000 person-years). Relative risk for type 2 diabetes was 1.16 times higher among those in the insomnia group vs. controls (95% CI, 1.1-1.19).
When stratified by age, risk for developing type 2 diabetes among those with insomnia was highest among those aged 40 years or younger when compared with controls (HR = 1.31; 95% CI, 1.14-1.55), followed by those aged 41 to 65 years (HR = 1.24; 95% CI, 1.17-1.35) and those aged at least 65 years (HR = 1.06; 95% CI, 0.97-1.12).
Among adults with insomnia, type 2 diabetes risk increased markedly with insomnia duration. Compared with controls, those with diagnosed insomnia followed for at least 8 years had a 50% increased risk for developing type 2 diabetes (HR = 1.51; 95% CI, 1.2-1.86), whereas those with diagnosed insomnia followed for 4 years or less had a 14% increased risk compared with controls (HR = 1.14; 95% CI, 1.03-1.17).
“In addition to conventional risk factors, such as obesity, diet and exercise, the strategies for type 2 diabetes prevention should include the treatment of sleep problems, which would enable more comprehensive type 2 diabetes care,” the researchers wrote.
The researchers noted that the database did not contain laboratory or BMI data, and the effect of hypnotics on the association between insomnia and type 2 diabetes was not evaluated, which may have caused potential bias. – by Regina Schaffer
Disclosures: The Taiwan Nurses Association supported this study. The authors report no relevant financial disclosures.
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