Partial sleep restriction decreases insulin sensitivity in type 1 diabetes
Open accessAbstract
OBJECTIVE: Sleep restriction results in decreased insulin sensitivity and glucose tolerance in healthy subjects. We hypothesized that sleep duration is also a determinant of insulin sensitivity in patients with type 1 diabetes. RESEARCH DESIGN AND METHODS: We studied seven patients (three men, four women) with type 1 diabetes: mean age 44 +/- 7 years, BMI 23.5 +/- 0.9 kg/m(2), and A1C 7.6 +/- 0.3%. They were studied once after a night of normal sleep duration and once after a night of only 4 h of sleep. Sleep characteristics were assessed by polysomnography. Insulin sensitivity was measured by hyperinsulinemic euglycemic clamp studies with an infusion of [6,6-(2)H(2)]glucose. RESULTS Sleep duration was shorter in the night with sleep restriction than in the unrestricted night (469 +/- 8.5 vs. 222 +/- 7.1 min, P = 0.02). Sleep restriction did not affect basal levels of glucose, nonesterified fatty acids (NEFAs), or endogenous glucose production. Endogenous glucose production during the hyperinsulinemic clamp was not altered during the night of sleep restriction compared with the night of unrestricted sleep (6.2 +/- 0.8 vs. 6.9 +/- 0.6 micromol x kg lean body mass(-1) x min(-1), NS). In contrast, sleep restriction decreased the glucose disposal rate during the clamp (25.5 +/- 2.6 vs. 22.0 +/- 2.1 micromol x kg lean body mass(-1) x min(-1), P = 0.04), reflecting decreased peripheral insulin sensitivity. Accordingly, sleep restriction decreased the rate of glucose infusion by approximately 21% (P = 0.04). Sleep restriction did not alter plasma NEFA levels during the clamp (143 +/- 29 vs. 133 +/- 29 micromol/l, NS). CONCLUSIONS: Partial sleep deprivation during a single night induces peripheral insulin resistance in these seven patients with type 1 diabetes. Therefore, sleep duration is a determinant of insulin sensitivity in patients with type 1 diabetes.
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Small-scale experimental studies have shown that short-term sleep deprivation may lead to metabolic dysregulation, elevated inflammation, and elevated blood pressure.
“Small-scale experimental studies have shown that short-term sleep deprivation may lead to metabolic dysregulation[29-34], elevated inflammation[35, 36], and elevated blood pressure[37].”
From Habitual sleep duration associated with self-reported and objectively determined cardiometabolic risk factors (2014) · cites this paper as [32]
In patients with type 1 diabetes, 1 night of sleep restriction to 4 h TIB vs 8.5 h TIB results in decreased glucose disposal, reflecting decreased insulin sensitivity.
“In patients with type 1 diabetes, 1 night of sleep restriction to 4 h TIB vs. 8.5 h TIB resulted in decreased glucose disposal, reflecting decreased insulin sensitivity, estimated by hyperinsulinemic clamp [35].”
From Metabolic effects of sleep disruption, links to obesity and diabetes (2014) · cites this paper as [35]
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“Contrary to the previous studies which observed short sleep duration impairing insulin sensitivity in both healthy [45] and T1D individuals [15], we observed worse estimated insulin sensitivity as the sleep time increased irrespective of confounders.”
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- Authors
- Donga, E., van Dijk, M., van Dijk, J. G., Biermasz, N. R., Lammers, G.-J., van Kralingen, K., Hoogma, R. P. L. M., Corssmit, E. P. M., & Romijn, J. A.
- Affiliations
- Leiden University Medical Center (NL)
- Department of Endocrinology and Metabolic Diseases, Leiden University Medical Centre, Leiden, the Netherlands;
- Department of Neurology, Leiden University Medical Centre, Leiden, the Netherlands;
- Department of Pulmonology, Leiden University Medical Centre, Leiden, the Netherlands;
- Groene Hart Ziekenhuis (NL)
- Corresponding author
- Donga, Esther
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2010-03-31
- Volume
- 33
- Issue
- 7
- Pages
- 1573-1577
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC2890361
- OpenAlex
- W2171783475
- Cited by
- 165
- References
- 25
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 16 · 2023: 10 · 2022: 19 · 2021: 19 · 2020: 9 · 2019: 11 · 2018: 7 · 2017: 5 · 2016: 11 · 2015: 19 · 2014: 9 · 2013: 6 · 2012: 3
- FWCI
- 7.54
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Leiden Repository (Leiden University) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Funders
- European Foundation for the Study of Diabetes
- Diabetes Fonds
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Keywords
- sleep restriction, sleep deprivation, insulin sensitivity, type 1 diabetes, peripheral insulin resistance, glucose disposal rate, endogenous glucose production, free fatty acids, hyperinsulinemic-euglycemic clamp, sleep duration
- MeSH terms
- Adult, Blood Glucose, Circadian Rhythm, Deuterium, Diabetes Mellitus, Type 1, Female, Humans, Hyperinsulinism, Insulin Resistance, Male, Middle Aged, Sleep Deprivation, Glucose Clamp Technique, Polysomnography, Glucose Intolerance
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