Sleep behaviours and associated habits and the progression of pre-diabetes to type 2 diabetes mellitus in adults: A systematic review and meta-analysis

Author:

Mostafa Samiul A123ORCID,Mena Sandra Campos4,Antza Christina25,Balanos George6,Nirantharakumar Krishnarajah378,Tahrani Abd A123

Affiliation:

1. Department of Diabetes, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

2. Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK

3. Centre of Endocrinology, Diabetes and Metabolism (CEDAM), Birmingham Health Partner, Birmingham, UK

4. Diabetes and Endocrinology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain

5. 3rd Department of Internal Medicine, “Papageorgiou” Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece

6. Sportex, University of Birmingham, Birmingham, UK

7. Institute of Applied Health Research, University of Birmingham, Birmingham, UK

8. Midlands Health Data Research UK, Birmingham, UK

Abstract

Introduction Certain sleep behaviours increase risk of type 2 diabetes mellitus (T2DM) in the general population, but whether they contribute to the progression from pre-diabetes to T2DM is uncertain. We conducted a systematic review to assess this. Methods Structured searches were performed on bibliographic databases (MEDLINE, EMBASE and CINAHL) from inception to 26/04/2021 for longitudinal studies/trials consisting of adults⩾18 years with pre-diabetes and sleep behaviours (short or long sleep duration (SD), late chronotype, insomnia, obstructive sleep apnoea, daytime napping and/or night-shift employment) that reported on incident T2DM or glycaemic changes. The Newcastle-Ottawa Scale was used for quality assessment. Results Six studies were included. Meta-analysis of three studies ( n = 20,139) demonstrated that short SD was associated with greater risk of progression to T2DM, hazard ratio (HR) 1.59 (95% CI 1.29-1.97), I2 heterogeneity score 0%, p < 0.0001, but not for long SD, HR 1.50 (0.86–2.62), I2 heterogeneity 77%, p = 0.15. The systematic review showed insomnia and night-shift duty were associated with higher progression to T2DM. Studies were rated as moderate-to-high quality. Conclusions Progression from pre-diabetes to T2DM increases with short SD, but only limited data exists for insomnia and night-shift duty. Whether manipulating sleep could reduce progression from pre-diabetes to T2DM needs to be examined.

Publisher

SAGE Publications

Subject

Cardiology and Cardiovascular Medicine,Endocrinology, Diabetes and Metabolism,Internal Medicine

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