Impact of insufficient sleep on dysregulated blood glucose control under standardised meal conditions,Diabetologia

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Impact of insufficient sleep on dysregulated blood glucose control under standardised meal conditions
Diabetologia ( IF 8.2 ) Pub Date : 2021-11-30 , DOI: 10.1007/s00125-021-05608-y
Neli Tsereteli ₁ , Raphael Vallat ₂ , Juan Fernandez-Tajes ₁ , Linda M Delahanty ₃ , Jose M Ordovas _{4,

5} , David A Drew _{6,

7} , Ana M Valdes ₈ , Nicola Segata _{9,

10} , Andrew T Chan _{6,

7} , Jonathan Wolf ₁₁ , Sarah E Berry ₁₂ , Matthew P Walker ₂ , Timothy D Spector ₁₃ , Paul W Franks _{1,

14}

Affiliation

Genetic & Molecular Epidemiology Unit, Lund University Diabetes Centre, Department of Clinical Sciences, Lund University, Malmö, Sweden.
Center for Human Sleep Science, Department of Psychology, University of California, Berkeley, CA, USA.
Diabetes Center, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
JM-USDA-Human Nutrition Research Diabetes Center on Aging at Tufts University, Boston, MA, USA.
IMDEA-Food, Madrid, Spain.
Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
NIHR Nottingham BRC at the Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK.
Department of Cellular, Computational and Integrative Biology, University of Trento, Trento, Italy.
European Institute of Oncology Scientific Institute for Research, Hospitalization and Healthcare, Milan, Italy.
Zoe Ltd, London, UK.
Department of Nutritional Research, Kings College London, London, UK.
Department of Twins Research, Kings College London, London, UK.
Harvard Chan School of Public Health, Boston, MA, USA.

Aims/hypothesis

Sleep, diet and exercise are fundamental to metabolic homeostasis. In this secondary analysis of a repeated measures, nutritional intervention study, we tested whether an individual’s sleep quality, duration and timing impact glycaemic response to a breakfast meal the following morning.

Methods

Healthy adults’ data (N = 953 [41% twins]) were analysed from the PREDICT dietary intervention trial. Participants consumed isoenergetic standardised meals over 2 weeks in the clinic and at home. Actigraphy was used to assess sleep variables (duration, efficiency, timing) and continuous glucose monitors were used to measure glycaemic variation (>8000 meals).

Results

Sleep variables were significantly associated with postprandial glycaemic control (2 h incremental AUC), at both between- and within-person levels. Sleep period time interacted with meal type, with a smaller effect of poor sleep on postprandial blood glucose levels when high-carbohydrate (low fat/protein) (p_interaction = 0.02) and high-fat (p_interaction = 0.03) breakfasts were consumed compared with a reference 75 g OGTT. Within-person sleep period time had a similar interaction (high carbohydrate: p_interaction = 0.001, high fat: p_interaction = 0.02). Within- and between-person sleep efficiency were significantly associated with lower postprandial blood glucose levels irrespective of meal type (both p < 0.03). Later sleep midpoint (time deviation from midnight) was found to be significantly associated with higher postprandial glucose, in both between-person and within-person comparisons (p = 0.035 and p = 0.051, respectively).

Conclusions/interpretation

Poor sleep efficiency and later bedtime routines are associated with more pronounced postprandial glycaemic responses to breakfast the following morning. A person’s deviation from their usual sleep pattern was also associated with poorer postprandial glycaemic control. These findings underscore sleep as a modifiable, non-pharmacological therapeutic target for the optimal regulation of human metabolic health.

Trial registration ClinicalTrials.gov NCT03479866.

Graphical abstract

中文翻译：

标准化膳食条件下睡眠不足对血糖控制失调的影响

目标/假设

睡眠、饮食和锻炼是代谢稳态的基础。在对重复测量、营养干预研究的二次分析中，我们测试了个体的睡眠质量、持续时间和时间是否会影响第二天早上对早餐的血糖反应。

方法

从 PREDICT 饮食干预试验中分析了健康成人的数据（N = 953 [41% 双胞胎]）。参与者在诊所和家中吃了超过 2 周的等能量标准化膳食。活动记录仪用于评估睡眠变量（持续时间、效率、时间），连续血糖监测仪用于测量血糖变化（>8000 餐）。

结果

睡眠变量与餐后血糖控制（AUC 增加 2 小时）显着相关，无论是在人之间还是在人内水平。睡眠时间与膳食类型相互作用，当食用高碳水化合物（低脂肪/蛋白质）（ p_相互作用 = 0.02）和高脂肪（p_相互作用 = 0.03）早餐时，睡眠不足对餐后血糖水平的影响较小参考 75 g OGTT。人体内睡眠时间有类似的相互作用（高碳水化合物：p_相互作用 = 0.001，高脂肪：p_相互作用 = 0.02)。无论膳食类型如何，人与人之间的睡眠效率都与较低的餐后血糖水平显着相关（均p < 0.03）。在人与人之间和人与人之间的比较中，发现晚睡中点（与午夜的时间偏差）与较高的餐后血糖显着相关（分别为p = 0.035 和p = 0.051）。