Short sleep duration is independently associated with obesity in with Type 2 diabetes

Abd Tahrani; Safia Begum; Shanaz Mughal; Kiran Dubb; Dev Banerjee; G Neil Thomas; Asad Ali; Biju Jose; Milan Piya; Martin Stevens; Anthony Barnett; Shahrad Taheri

Background: From population studies, short and long sleep duration are associated with obesity. This association has not been studied in patients with type 2 diabetes (T2D).

Methods: Design: Cross-sectional study of adult T2D patients recruited randomly from outpatient department of a large UK tertiary centre. Patients with known sleep-related disorders were excluded. Data were collected during one-to-one interviews. Sleep duration assessment: 7-day sleep diary including bedtimes and wake-times, and number and duration of naps. Adiposity was assessed using body mass index (BMI), waist and neck circumferences and fat mass. Obstructive sleep apnoea (OSA) risk was assessed using the Berlin questionnaire. Other data collected: demographics, past medical history, drug history, smoking, alcohol, blood pressure (BP) and a biochemical profile. Data presented as median (IQR) or percentages.

Results: Seventy-seven patients returned questionnaires (70% response rate). Participants characteristics: age 61 years (52–68), 59.7% men, 57% white Caucasians, diabetes duration 10 years (6–17), BP 130 (121–141)/80 (74–86) mmHg, BMI 32.8 (29–36.1) kg/m², waist circumference (WC) 112 (101–122) cm, neck circumference (NC) 41 (38–43) cm, fat mass 32.4 (25.2–43.9) kg, HbA1c 7.6 (7–8.7) %, 48% on insulin, 14.3% taking exenatide, average sleep duration 7.9 (7.2–8.9) hours/night, 60% had naps (number 4 (1–7) naps/weeks, duration 145 (35–375) minutes/weeks), 79% were at ‘high–risk’ for OSA. 18, 60 and 22% had short (<7), normal (7–9) and long (>9 h/night) sleep duration, respectively.

There was a stepwise reduction in BMI and WC between short, normal and long sleepers (BMI: 36.3 (32.4–42.4) versus 32.8 (30.7–35.7) versus 28.8 (25.8–35) kg/m², P=0.008; waist circumference: 119 (109–134) versus 112 (103–122) versus 103 (94–113) cm, P=0.05)

Sleep duration correlated negatively with BMI (r=−0.34, P=0.003), waist circumference (r=−0.31, P=0.007), NC (r=−0.2, P=0.09) and fat mass (r=−0.2, P=0.07). Multivariate linear regression, that included age, gender, ethnicity, HbA1c, diabetes duration, diabetes treatment, alcohol, smoking, napping, OSA risk and sleep duration, showed that short sleep was independently associated with BMI (B=−0.24, P=0.037), waist circumference (B=−0.28, P=0.027) and NC (B=−0.25, P=0.029) but not fat mass (B=−0.19, P=0.08).

Conclusions: Short sleep duration is independently associated with obesity in patients with T2D. Further studies examining the impact of sleep duration on adiposity in T2D are needed.

Endocrine Abstracts

P183