Short sleep duration associated with increased risk of diabetes

1. Short sleep duration (<6 hours per day) and regular or occasional snoring were associated with a higher risk of Type 2 Diabetes among women with a history of Gestational Diabetes (GD).

2. More frequent snoring was associated with an unfavorable metabolic profile.

Evidence Rating Level: 2 (Good) 

Women with a history of gestational diabetes (GD) are nearly 10 times more likely to develop type 2 diabetes (T2D) later in life than those without GD history. Although shortened sleep duration has been associated with an increased risk of T2D, research on the role of sleep in the progression from GD to T2D is lacking. This prospective cohort study thus examined the associations of sleep duration and quality with the risk of T2D in women with a history of GD. This study analyzed data from the Nurses’ Health Study II, an ongoing prospective cohort study of female nurses aged 22-44, and included women who reported a history of GD on the questionnaire administered between June 2002 and June 2003. Women in the study were followed up biennially until June 2021. Among the 2,891 women with a history of GD included (mean [SD] age, 45.3 [4.4] years), 563 women (19.5%) developed T2D over 42,155 person-years of follow-up (mean [SD] follow-up duration, 17.3 [5.1] years). Compared with women who reported rarely snoring, those with occasional or regular snoring had a higher risk of T2D, with adjusted hazard ratios (HRs) of 1.54 (95% CI, 1.18-2.02) and 1.61 (95% CI, 1.21-2.13), respectively. Compared with women who slept 7 to 8 hours per day, those who slept less (<6 hours per day) had a higher risk of T2D (HR, 1.32; 95% CI, 1.06-1.64). Women who both slept < 6 hours per day and snored regularly had the highest risk of developing T2D (HR, 2.06; 95% CI, 1.38-3.07) compared with women who slept 7 to 8 hours per day and almost never snored. Compared with women who rarely snored, more frequent snoring was also associated with higher levels of glycated hemoglobin (HbA1c) (least-squares means [LSM], 5.89; 95% CI, 5.75-6.02), C-peptide (LSM, 4.30; 95% CI, 3.70-4.99), and insulin levels (LSM, 11.25; 95% CI, 8.75-14.40) (P = .01 for all). Overall, this study found that short sleep durations of < 6 hours per day and frequent snoring were associated with an increased risk of T2D among women with a history of GD, and that snoring frequency was also linked to an unfavorable metabolic profile. These results suggest that improving sleep health may be important in preventing progression from GD to T2D. 

Click to read the study in JAMA Network Open

Image: PD

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