ECE2017 Eposter Presentations: Diabetes, Obesity and Metabolism Diabetes complications (102 abstracts)
Somnological parameters for patients with type 1 diabetes and nocturnal hypoglycemia
Ina Darashkevich 1 , Tatiana Mokhort 2 , Lola Nikanava 1 , Ludmila Smirnova 1 & Serhej Tishkovsky 1
1Grodno State Medical University, Grodno, Belarus, 2Belarus State Medical University, Minsk, Belarus.
Objective: To determine the effects of hypoglycemia while sleeping on somnological parameters for patients with type 1 DM.
Materials and methods: The study included 57 person with type 1 DM (Group 1 – patients with blood glucose levels (BGL) during sleep <3.9 mmol/l; Group 2 – Patients with BGL – from 3.9 to 10.0 mmol/l. The examination included: daily monitoring of blood glucose by ‘CGMSGold’ (‘MedtronikMINIMED’ (USA)), polysomnography «SOMNOlab2 (PSG) Polysomnography (R & K)», the definition of HbA1c.
Results: Table
| Indicator | Group 1 n=14 Me [25;75] | Group 2 n=43 Me [25;75] |
| BGL during sleeptime (mmol/l)0 | 2.35[2.00;3.10]* | 6.10[4.10;7.50] |
| Hypoglycemia «before sleep» (%) | 7.00[3.00;27.00]* | 5.23[0.00;5.00] |
| HBA1c (%) | 7.00[6.00;8.10] | 7.67[6.40;9.00] |
| Total sleep time (TST) (h) | 6.24[5.40;7.10]* | 5.30[4.51;6.20] |
| REM (%) | 39.50[26.00;48.00]* | 29.70[23.00;45.80] |
| N1(%) | 14.11[10.60;23.00]* | 8.80[4.70;14.30] |
| N2(%) | 38.8[35.20;61.40] | 48.20[34.00;53.30] |
| N3(%) | 3.00[1.20;6.10] | 3.44[2.30;6.30] |
| N4(%) | 1.45[0.00;2.89]* | 3.00[1.00;8.40] |
| *P<0.05. | ||
Discussion and conclusions: For patients of Group 2 marked shortening of TST – 5.30 [4.51; 6.20] hours vs 6.24 [5.40; 7.10] hours (P=0.0219). Night hypoglycemia extend REM-sleep (39.50 [26.00; 48.00]% vs 29.70 [23.00; 45.80]% in the comparison group (P=0.0479), N1 sleep stage (14.11 [10.60; 23.00]% vs8.80 [4.70; 14.30]% (P=0.0110), as well as reduce the N4 stage of sleep (1.45 [0.00; 2.89]% vs 23.00 [1.00; 8.40]%). The share of hypoglycemia ‘before sleep’ extends N1 (r=0.5442); an increase in the length of N1 leads to a reduction in the duration of the deep stages of slow-wave sleep N3 (r=−0.6835), N4 (r=−0.5673); an increase in the duration of REM reduces N3 (r=−0.5887).
Conclusion: Hypoglycemia during sleep lengthens REM-sleep, REM sleep so reduces glycemia, providing interactive effects relative to each other, helping to increase the N1 and reduction of deep sleep stage (N3 and N4).
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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