Endocrine Abstracts

Introduction: Diabetes mellitus, evolving as a silent epidemic, is a chronic metabolic disease associated with high morbidity and mortality among the patients. In addition to its micro and macrovascular complications as well as its impact on quality of life, evidence has shown that patients with diabetes mellitus are prone to poor sleep quality [1]. This study aims to evaluate the sleep quality (SQ) in patients with type 2 diabetes mellitus (T2DM) and to determine possible factors that may alter the SQ of these patients.

Methods: A cross-sectional study was conducted in 100 adults with T2DM. Patients’ demographic and anthropometric characteristics, diabetes related complications and biological parameters were collected. SQ was evaluated using the Pittsburgh sleep quality index (PSQI) in its arabic-validated version. The total PSQI score was obtained by adding seven scores corresponding to seven subcomponents of sleep quality, ranging between 0 and 21. PSQI score >5 indicates significant sleep disturbance and categorizes the subjects as poor sleepers.

Results: Mean age was 54.45±7.13 years with female predominance (72%). Mean diabetes duration was 12.67±7.35 years, mean glycated hemoglobin was 9.69±2.02 % and mean BMI was 29.49±4.97 Kg/m². Half of our sample was obese (49%). Twenty two percent of patients used oral glucose-lowering drugs (OGLDs), mostly sulfonylureas (87,5%), while 78% used insulin. Within the insulin user subgroup, 67% were prescribed metformin, and 12% were on iSGLT2. Retinopathy, nephropathy and peripheral neuropathy were found, respectively in 40%, 22% and 27% of patients. Mean DN4 score was 1.82±1.65. Mean ALT and AST levels were 20.73±7.90 UI/l and 20.72±7.08 UI/l, respectively. The mean PSQI score was 7.89±3.69 with extremes ranging from 1 to 15 and 69% of our patients had poor sleep quality. Patients with poor SQ had significantly higher prevalence of mild retinopathy (87.5% vs 12.5%; P=0.049) and peripheral neuropathy (86.4% vs 13.6%; P=0.034). Additionally, a significant disturbance of sleep was higher among patients using sulfonylureas (90% vs 10%; P=0.021). Patients with poor SQ had higher DN4 score (2.06±1.74 vs 1.17±1.21; P=0.017), higher ALT levels (21.93±8.04 UI/l vs 17.70±5.94 UI/l; P=0.016) and AST levels (21.86±7.89 UI/l vs 17.96±4.61; P=0.021).

Conclusion: highlights the high occurrence of poor sleep quality among patients with type 2 diabetes mellitus (T2DM), particularly in the presence of microvascular complications. These results underscore the importance of advocating for screening this disorder in this population

References: 1. Surani S, Brito V, Surani A, Ghamande S. Effect of diabetes mellitus on sleep quality. World J. Diabetes 2015; 6:868–73.