scholarly journals Associations Between Objective Sleep Behaviors and Blood Glucose Variability in Young Children With Type 1 Diabetes

2020 ◽  
Author(s):  
Alexandra D Monzon ◽  
Arwen M Marker ◽  
Amy E Noser ◽  
Mark A Clements ◽  
Susana R Patton
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Young Children ◽  
Sleep Onset ◽  
Glycemic Variability ◽  
Glucose Variability ◽  
Sleep Onset Latency ◽  
Onset Latency ◽  
Blood Glucose Variability

Abstract Background Young children with Type 1 diabetes (T1D) are at risk for extreme blood glucose variability, a risk factor for suboptimal glycated hemoglobin A1c (HbA1c) and long-term health complications. We know that a reciprocal relationship exists between sleep and glycemic outcomes in older youth with T1D; however, little research has examined objective sleep in young children (<7 years) with T1D. Purpose This study examines bidirectional associations between sleep behaviors and glycemic variability in young children with T1D. Methods Thirty-nine young children with T1D (Mage 4.33 ± 1.46 years; MHbA1c 8.10 ± 1.06%) provided accelerometry data to objectively measure sleep onset latency, number of nighttime awakenings, and total sleep time. We also assessed HbA1c, average blood glucose, and glycemic variability (i.e., standard deviation of blood glucose from device downloads). We evaluated bidirectional relationships using multilevel modeling in SAS, with weekday/weekend as a Level 2 moderator. Results Children averaged 8.5 ± 1.44 hr of sleep per night, but only 12.8% met current sleep recommendations. Children experienced more nighttime awakenings, higher blood glucose, and more glycemic variability on weekends. Sleep onset latency and nighttime awakenings predicted greater glycemic variability on weekends, and weekend glycemic variability predicted increased nighttime awakenings. Conclusions Most young children with T1D did not meet sleep recommendations. Young children experienced more nighttime awakenings, higher blood glucose, and increased glycemic variability on weekends only, when routines may be less predictable. Findings suggest that one way families of young children with T1D may be able to decrease glycemic variability is to keep consistent routines on weekdays and weekends.

scholarly journals 0927 Variations in Sleep and Glucose in Adolescents with Type 1 Diabetes

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A352-A353
Author(s):  
S Griggs ◽  
N S Redeker ◽  
S Jeon ◽  
M Grey
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Sleep Duration ◽  
Sleep Onset ◽  
Glucose Variability ◽  
Poor Sleep ◽  
Short Sleep Duration ◽  
High Blood Glucose ◽  
Short Sleep

Abstract Introduction The association between short sleep duration and poorer glycemic control in adolescents ages 10-16 with type 1 diabetes (T1D) is well established. Researchers have used cross-sectional, between-subjects’ methods, with limited focus on the potential intraindividual variation among these variables. The purpose of this analysis was to examine the within person associations between glucose variability indices (J index, low/high blood glucose index, time in range) and sleep characteristics (bedtime, waketime, total sleep time, sleep efficiency, wake after sleep onset [WASO], awakenings, and sleep fragmentation index) in adolescents with T1D. Methods Adolescents monitored their sleep and glucose patterns concurrently for 3-7 days with a wrist actigraph on their non-dominant wrist and either their own continuous glucose monitor (CGM) or a provided blinded CGM. General linear mixed models (GLMM) were used to determine within-person and day level associations. Results The sample included 38 adolescents (M age 13.4±1.8; 37.8% male; M A1C 8.2±1.2%). Average glucose levels were controlled in all GLMMs. Adolescents had earlier waketimes on days when more time was spent in hypoglycemia <70mg/dL (β=-0.15, p<0.001). At the person level, adolescents had greater WASO with more % time spent in severe hypoglycemia <54mg/dL with more severe low blood glucose indices (β=0.35, p<0.01 and β=0.34, p<0.01 respectively). At the daily level, adolescents had greater WASO (β=0.20, p=0.01) and more awakenings (β=0.16, p=0.04) on the days they had more overall glucose variability (J index) and more severe high blood glucose indices (β=0.17, p=0.04), but were less likely to have more % time in hypoglycemia (β=-0.15, p=0.02). Conclusion Glucose variability was positively associated with poor sleep (e.g., WASO and awakenings) in adolescents with T1D both at the daily and intraindividual level. Monitoring over a longer period of time in subsequent studies would allow researchers to determine the within person associations between habitual short sleep duration and glucose variability. Support NINR T32NR0008346 & P20NR014126, Medtronic MiniMed provided CGMs at a discounted rate for the study.

scholarly journals Association of morning fasting blood glucose variability with insulin antibodies and clinical factors in type 1 diabetes

2016 ◽  
Vol 63 (7) ◽  
pp. 603-609 ◽  
Author(s):  
Chihiro Yoneda ◽  
Kanako Tashima-Horie ◽  
Sayaka Fukushima ◽  
Satoko Saito ◽  
Sayoko Tanaka ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Fasting Blood Glucose ◽  
Glucose Variability ◽  
Insulin Antibodies ◽  
Clinical Factors ◽  
Blood Glucose Variability

Carbohydrate counting accuracy and blood glucose variability in adults with type 1 diabetes

2013 ◽  
Vol 99 (1) ◽  
pp. 19-23 ◽  
Author(s):  
A.S. Brazeau ◽  
H. Mircescu ◽  
K. Desjardins ◽  
C. Leroux ◽  
I. Strychar ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Glucose Variability ◽  
Carbohydrate Counting ◽  
Blood Glucose Variability

scholarly journals No association between fear of hypoglycemia and blood glucose variability in type 1 diabetes: The cross-sectional VARDIA study

2019 ◽  
Vol 33 (8) ◽  
pp. 554-560 ◽  
Author(s):  
Pierre Jean Saulnier ◽  
Claire Briet ◽  
Elise Gand ◽  
Lucy Chaillous ◽  
Severine Dubois ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Glucose Variability ◽  
Cross Sectional ◽  
Fear Of Hypoglycemia ◽  
Blood Glucose Variability ◽  
The Cross

Glycated Albumin to Glycated Hemoglobin Ratio is a Sensitive Indicator of Blood Glucose Variability in Patients with Fulminant Type 1 Diabetes

2012 ◽  
Vol 51 (11) ◽  
pp. 1315-1321 ◽  
Author(s):  
Hiroaki Matsumoto ◽  
Yuko Murase-Mishiba ◽  
Naomune Yamamoto ◽  
Saya Sugitatsu-Nakatsukasa ◽  
Saeko Shibasaki ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Glycated Hemoglobin ◽  
Glycated Albumin ◽  
Glucose Variability ◽  
Sensitive Indicator ◽  
Fulminant Type 1 Diabetes ◽  
Blood Glucose Variability ◽  
Fulminant Type

scholarly journals 1005 Characterizing Sleep and Glycemia in Emerging Adults with Type 1 Diabetes

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A382-A382
Author(s):  
S Griggs ◽  
N S Redeker ◽  
M Grey
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Emerging Adults ◽  
Sleep Onset ◽  
Glucose Variability ◽  
High Risk Population ◽  
Sleep Onset Latency ◽  
True Nature ◽  
Psychomotor Vigilance

Abstract Introduction Type 1 Diabetes (T1D) affects 1.25 million Americans, and only 14% of emerging adults (ages 18-30 years) achieve targets for glycemic control (A1C < 7.0%). Sleep deficiency, less than 6.5 hours total sleep time (TST), is associated with poorer glycemic control. Methods Emerging adults with T1D wore a wrist actigraph and their own or provided continuous glucose monitor (CGM) concurrently 24 hours/day for 6-8 days. Participants completed a 10-minute psychomotor vigilance test (PVT) on a device, 3-minute Trail Making Test on paper, and questionnaires including twice daily Pittsburgh sleep diaries in Research Electronic Data Capture (REDCap). TST, sleep onset latency (SOL), sleep efficiency (SE), wake after sleep onset (WASO), and sleep fragmentation index (SFI) were determined via actigraphy, glycemic control via A1C, and glucose variability via CGM. The purpose of this descriptive study was to explore associations between TST, sleep variability (SD of TST), neurocognitive function (psychomotor vigilance and executive function) and diabetes outcomes (glycemia and distress). Results The sample included 36 emerging adults (mean age 22.8±3.1; 30.6% male; 91.7% White, 86.1% non-Hispanic; A1C mean 7.1±1.0%, BMI 27.3±4.8 kg/m2). Mean TST was 7.1±1.2 hours, SOL was 19.7±13.5 minutes, SE was 85.5±4.6%, WASO was 34.7±18.2 minutes, and SFI was 17.7±6.2. Shorter TST was associated with more severe sleepiness (r=-0.48,p=0.004) and more diabetes distress (r=-0.37, p=0.03). More sleep variability was associated with more severe sleepiness (r=0.36, p=0.03), longer response times (RT) ≥ 500ms (rho=0.39, p=0.02) measured via PVT, more nocturnal glucose variability (r=0.38, p=0.04), greater mean daily differences in glucose levels (r=0.42, p=0.02). Shorter mean RT was associated with more time in glucose range (rho=-0.37, p=0.04). Conclusion Improving TST and sleep variability are potential therapeutic targets to improve glucoregulation in this high-risk population. Researchers should consider within-person multi-level modeling to inform our understanding of the true nature of the sleep-glucose association in emerging adults with T1D. Support T32 NR0008346, Sigma Theta Tau International, Dexcom provided continuous glucose monitors (G4) free of charge for participants who did not have their own device.

Impact of blood glucose variability on carotid artery intima media thickness and distensibility in type 1 diabetes mellitus

2013 ◽  
Vol 22 (6) ◽  
pp. 355-361 ◽  
Author(s):  
Francesca Cesana ◽  
Cristina Giannattasio ◽  
Stefano Nava ◽  
Francesco Soriano ◽  
Gianmaria Brambilla ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Carotid Artery ◽  
Type 1 Diabetes Mellitus ◽  
Intima Media Thickness ◽  
Glucose Variability ◽  
Media Thickness ◽  
Blood Glucose Variability
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