Endocrine Abstracts

Fluctuations of glycemia, the rate of glycemia decreasing, the chronic decompensation type 1 diabetes adversely influenceon diabetic complications development. Increased glycemia during sleep leads to a change in the structure of sleep and a decrease in its functions.

The aim of the study was to assess the effect of glycemic values and it’s correction during sleep on somnological indicators.

Materials and methods: The study included 7 type 1 diabetes patients who received insulin therapy in a basal-bolus regime. All participants were assessed for glycated hemoglobin (HbA1c) (Architectc8000, Abbott, USA), polysomnographic study “SOMNOlab2, Weinmann R&K” with continuous glucose monitoring (CGM) “CGMSGold” Medtronic Mini Med USA) for two diagnostic nights. CGM was performed in parallel with the PSS in the second diagnostic night.In case of detecting hyperglycemia during sleeping according to CGM (glucose level (GL) >7.0 mmol/l) the correction of insulin therapy was performed, with repeated implementation of the complex study (PSS and CGM) with an interval of 5–7 days (Table 1). All patients were in type 1 diabetes decompensation stage (HbA1c 8.95%). Before the insulin therapy correction, fluctuations in glycemia at night were recorded in the range 8.2–13.8 mmol/l, after correction of insulin therapy - 5.50–6.50 mmol/l. Achievement of normoglycemia was accompanied by an increase in the coefficient of sleep efficiency to 86.7% vs 70.0% before correction. The duration of WASO was maximal for patients with fluctuations in glycaemia from 8.20 to 13.80 mmol/l (71 min vs 31 min). Similar results were obtained from the evaluation of the proportion of REM sleep reduction from 39.9 to 35.4%, and an increasing of N3 (2.80 vs 5.10) and N4 (1.20 vs 3.70) stages.

Conclusions: Achievement of glycemia 5.5–5.6 mmol/l for type 1 diabetes in decompension (HbA1c 8.95%) improves the structural parameters of sleep: reduces REM phase, prolongs the deep stages of slow sleep (N3, N4), and improves sleep efficiency, reduces the duration of WASO.