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Cited by 322Sleep and related disordersCircadian rhythm and melatoninSleep and Work-Related Fatigue

Incidence of Diabetes in Middle-Aged Men Is Related to Sleep Disturbances

Nilsson, Peter M., Rööst, Mattias, Engström, Gunnar, Hedblad, Bo, Berglund, Göran·2004·Diabetes Care
DOI 10.2337/diacare.27.10.2464
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Abstract

OBJECTIVE: Sleep deprivation in healthy men has been experimentally found to result in disturbances in glucose metabolism and in sympathovagal imbalance. The aim of the present study was to investigate whether sleep disturbances and elevated resting heart rate are associated with increased risk of developing diabetes. RESEARCH DESIGN AND METHODS: A group of 6,599 initially healthy, nondiabetic men aged 44.5 +/- 4.0 years took part in a prospective, population-based study in Malmö, Sweden. The incidence of diabetes during a mean follow-up of 14.8 +/- 2.4 years was examined in relation to self-reported difficulties in falling asleep and resting heart rate at baseline. Diabetes was assessed at follow-up in all subjects by questionnaire and in a subgroup of 1,551 men by blood glucose measurement. RESULTS: A total of 615 (9.3%) subjects reported either difficulties in falling asleep or regular use of hypnotics (seen as markers of sleep disturbances), and 158 (2.4%) subjects reported both of these. Altogether, 281 (4.3%) of the men developed diabetes during the follow-up period. Logistic regression models showed difficulties in falling asleep or regular use of hypnotics (odds ratio [OR] 1.52 [95% CI 1.05-2.20]) and resting heart rate (OR per 10 bpm 1.13 [0.99-1.30]) to be associated with development of diabetes when full adjustments were made for baseline age, biological risk factors, lifestyle, family history of diabetes, and social class. CONCLUSIONS: The results suggest that sleep disturbances and, possibly, elevated resting heart rate, in middle-aged men, are associated with an increased risk of diabetes.

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45 of 45 references verified0 citation errors · 0 not checkable

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  • Studies such as [20,25,26,31] implemented these technologies to enhance patient self-monitoring, treatment adherence, and real-time behavioral tracking.

    “Studies such as [20,25,26,31] implemented these technologies to enhance patient self-monitoring, treatment adherence, and real-time behavioral tracking.”

    From Methodological Approaches in Studying Type-2 Diabetes-Related Health Behaviors—A Systematic Review (2025) · cites this paper as [20]

  • Among the nine technology-assisted studies, physical activity was the most commonly targeted behavior (67%, 6/9 studies), followed by medication adherence (44%, 4/9), dietary behaviors (33%, 3/9), and self-monitoring of blood glucose (22%, 2/9).

    “Among the nine technology-assisted studies, physical activity was the most commonly targeted behavior (67%, 6/9 studies), followed by medication adherence (44%, 4/9), dietary behaviors (33%, 3/9), and self-monitoring of blood glucose (SMBG) (22%, 2/9) [10,20,23], [25,26,30,31,34,37].”

    From Methodological Approaches in Studying Type-2 Diabetes-Related Health Behaviors—A Systematic Review (2025) · cites this paper as [20]

  • A small but increasing number of studies integrate biometric markers such as serum uric acid, BMI, and HbA1c as outcome variables alongside behavioral data.

    “Additionally, a small but increasing number of studies are beginning to integrate biometric markers such as serum uric acid levels, BMI, and HbA1c as outcome variables alongside behavioral data [9,20].”

    From Methodological Approaches in Studying Type-2 Diabetes-Related Health Behaviors—A Systematic Review (2025) · cites this paper as [20]

  • Difficulty in falling asleep resulted in a greater incidence of diabetes after 4.2-14.8 years of follow up.

    “Difficulty in falling asleep resulted in a greater incidence of diabetes after 4.2–14.8 years of follow up.32–34”

    From Interacting epidemics? Sleep curtailment, insulin resistance, and obesity (2012) · cites this paper as [33]

  • Impaired sleep quality, such as difficulty initiating or maintaining sleep, has been associated with increased odds of developing diabetes in multiple studies.

    “Furthermore, impaired sleep quality, such as difficulty initiating or maintaining sleep, has been associated with increased odds of developing diabetes in multiple studies [188–193].”

    From Association between sleep deficiency and cardiometabolic disease: implications for health disparities (2016) · cites this paper as [189]

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Authors
Nilsson, P. M., Rööst, M., Engström, G., Hedblad, B., & Berglund, G.
Affiliations
  • Department of Medicine, University Hospital, Malmö, Sweden
  • Department of Community Medicine, University Hospital, Malmö, Sweden
ORCID
Nilsson, Peter M.
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2004-10-01
Volume
27
Issue
10
Pages
2464-2469
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/diacare.27.10.2464
OpenAlex
W2166933554
Cited by
322
References
45
Citations by year
2026: 5 · 2025: 6 · 2024: 8 · 2023: 3 · 2022: 7 · 2021: 3 · 2020: 11 · 2019: 9 · 2018: 16 · 2017: 17 · 2016: 22 · 2015: 24 · 2014: 17 · 2013: 21 · 2012: 24
FWCI
20.64
Type
journal article
Language
en
Open access
closed
Locations
  • Diabetes Care (publishedVersion)
  • PubMed (publishedVersion)
  • Lund University Publications (Lund University) (submittedVersion)
Funders
  • Malmö Högskola
  • Svenska Läkaresällskapet
  • Medical Research Council
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
Keywords
diabetes incidence, sleep disorders, sleep deprivation, difficulty falling asleep, hypnotic use, resting heart rate, middle-aged men, glucose metabolism, sympathovagal imbalance, diabetes risk factors
MeSH terms
Age Factors, Analysis of Variance, Diabetes Mellitus, Type 2, Follow-Up Studies, Glucose Tolerance Test, Humans, Male, Middle Aged, Prospective Studies, Surveys and Questionnaires, Severity of Illness Index, Sleep Wake Disorders, Sweden, Cohort Studies, Comorbidity, Prevalence, Multivariate Analysis, Logistic Models, Polysomnography, Risk Assessment

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