Relationship Between Sleep and Type 2 Diabetes: Revealing the Silent Killers

TL: DR

• Improper sleep cycles dramatically increase your insulin resistance and in turn worsen or lean towards the development of Type 2 Diabetes.
• Poor sleep habits spoil your metabolic health by increasing inflammatory markers and changing hormone levels that regulate glucose—this multiplies the probability of diabetic problems.
• Track the associated biomarkers with sleep and work on regular improvement techniques for managing diabetes like a conscious healthcare enthusiast.?

The Longevity Lesson Today

The critical connection between sleep and type 2 diabetes (T2D) management is a medical lesson you must understand. Adequate sleep is often overlooked yet plays a fundamental role in regulating blood sugar levels and overall metabolic health. Enhancing your sleep hygiene can welcome notable improvements in diabetes management, potentially reducing dependency on medication and preventing long-term complications.?

Emerging scientific evidence supports the notion that sleep—both its quality and quantity—is key to regulating glucose metabolism and insulin sensitivity, both of which are pivotal in T2D management.?

Poor sleep can lead to impaired glucose tolerance, increased insulin resistance (IR), and heightened inflammatory responses. All these can precipitate or worsen diabetic conditions. You can expect ill effects on your body’s endocrine functions and disturbed circadian rhythms that dictate numerous metabolic processes.

From a physiological perspective, sleep deprivation affects hormones regulating hunger and satiety—ghrelin and leptin respectively. Greater ghrelin and decreased leptin due to poor sleep can result in increased appetite and caloric intake, leading you toward obesity. From pancreatic beta-cell dysfunction because of forced insulin generation to elevated cortisol levels, you need proper sleep to keep these T2D-related setbacks at bay.

CTA: Asses Your Risk to T2D ?and book a Consult With Me

Insights from a UK Biobank Study

The UK Biobank , a large-scale biomedical database and research resource, conducted an extensive study involving hundreds of thousands of participants.?

The study was a detailed analysis related to sleep patterns and their health consequences. It concluded that those who consistently reported sleeping under 6 hours/night were at a substantially higher risk of developing T2D compared to those sleeping 7-8 hours. This association was found to be strong, even after adjusting for other potential confounders like age, sex, body mass index (BMI), and lifestyle factors.

Additionally, the study indicated that short sleep durations are linked with a 30% higher risk of developing diabetes. This underlines the clear and measurable impact of sleep on metabolic health. Note that the study delved into possible mechanisms like:

• Less sleep leads to hormonal imbalances
• Disturbed sleep affects appetite regulation
• Patients are susceptible to increased insulin resistance
• Increased inflammatory markers and stress hormone levels
• Negative effects on glucose metabolism

I recommend routine sleep duration assessments in medical evaluations for diabetes risk. We can identify interventions aimed at extending sleep duration, tweaking dietary habits, and solving root causes related to your sleep-time discrepancies. As a longevity physician, I intend to manage your sleep-associated problems and keep you distant from diabetes in the long run.

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Biological Mechanisms Linking Sleep Deprivation to T2D

Let’s discover a few biological mechanisms that closely link the problem of sleep deprivation to T2D:

• Increased insulin resistance: Chronic sleep deprivation is implicated in significant disruptions to glucose metabolism primarily through its impact on insulin signaling pathways. Lack of sleep will reduce your insulin receptors’ activity on cell surfaces, lowering your glucose intake and growing your blood sugar level.

You want to stay clear of this phenomenon since this, and prolonged sleep deficits, reflect a state of insulin resistance—a precursor to T2D .

• Role of inflammatory markers: Sleep loss is strongly linked with heightened systemic inflammation, evidenced by increased levels of C-reactive protein (CRP) and serum amyloid A (SAA). Remember that these biomarkers are often used to indicate inflammation and also actively participate in the pathophysiology of insulin resistance. It would help to get your diabetes risk checked if you’re a victim of sleep bruxism or sleep apnea.

Scientifically speaking, their elevated levels during periods of insufficient sleep contribute directly to cellular mechanisms. This impairs insulin signaling and endothelial function, thereby elevating diabetes risk.?

• Pathophysiological insights: The long list of inflammatory responses triggered by inadequate sleep involves complex interactions between immune cells and cytokines . This inflammatory setting adversely affects the pancreas and its insulin-producing beta cells, compromising insulin secretion and function over time.?

Exploring How Poor Sleep Affects GLP-1 and NEFA Metabolism

Let’s now study how these biomarkers are affected by unhealthy sleep cycles:

GLP-1 (Glucagon-Like Peptide-1)

A lot of you would have heard of this molecule, through the lens of weight loss drugs, popularised by the name Ozempic which is a GLP-1 Agonist. But did you know that a similar effect can be earnt via sleeping more? GLP-1 is a hormone involved in the incretin effect, which enhances insulin secretion in response to meals. Inadequate sleep reduces GLP-1 levels , impacting the insulinotropic effects of this hormone and leading to inefficient glucose control and higher postprandial glucose levels.?

If you’re struggling with less-than-average REM sleep cycles due to low GLP-1 levels, chances are you may also have to deal with glucose intolerance and insulin resistance.?

To add, low GLP-1 levels also affect satiety signals, increasing food intake and weight gain, further complicating diabetes management.?

NEFA (Non-Esterified Fatty Acids) Metabolism

NEFAs are released into the blood by lipolysis of triglycerides, being a major energy source for many tissues. However, elevated levels call for insulin resistance in your muscles and liver. In fact, NEFA levels rise overnight because of an increase in lipolysis caused by poor sleep cycles.?

Keep in mind that restricting yourself from proper sleep can increase NEFA levels and affect your overall metabolic flexibility. This effect highlights why adequate sleep is vital in maintaining lipid balance and preventing metabolic disturbances.

How Can a Single Night of Less Sleep Affect Your IR?

Here’s a quick summary of sleep deprivation’s role in IR:

• Cutting sleep to approx. four hours for a single night results in about a 30%-40% drop in glucose tolerance—an indicator of insulin sensitivity
• Increases sympathetic nervous system activity and elevates cortisol levels—disrupting normal glucose metabolism
• One night of insufficient sleep may exhibit a level of IR 4x higher than your baseline levels
• Increases the secretion of counter-regulatory hormones like growth hormones and cortisol
• IR spikes can complicate glycaemic control and increase the risk of hyperglycemia.

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Your Longevity Homework

Given the variety of sleep data categories, tracking your sleep metrics manually can be challenging. Consider using wearable devices like Apple Watch and Fitbit or apps like Sleep Cycle and Mito to monitor your sleep patterns. Staying informed of your sleep quality may help you uncover patterns contributing to poor rest.

Be it for lesser late-night technology use or irregular sleep patterns, try setting a goal to achieve 7-8 hours of quality sleep each night. You can use the collected data to adjust your bedtime routine and reduce sleep disruptions.

I personally advise you to create a sleep-conducive environment in a cool, dark, and quiet bedroom. Install some blackout curtains and also prepare a pre-sleep routine including reading or deep breathing to relax yourself before bed. Most importantly, limit stimulants like caffeine, heavy meals, and blue light exposure before sleep time.

Do periodic checks on a body composition scale to stay updated about your muscle mass, fat percentage, and water levels. Opt for A1C and fasting insulin tests. The former provides your average blood sugar level over the past three months, and the latter assesses insulin sensitivity.??

Lastly, do you think your sleep quality is affecting your health??

CTA: Book A1C and Fasting Insulin Tests

References:

• https://www.ukbiobank.ac.uk/search-results?query=sleep+and+diabetes
• https://onlinelibrary.wiley.com/doi/10.1111/jsr.13392
• https://www.sleepfoundation.org/physical-health/lack-of-sleep-and-diabetes
• https://pubmed.ncbi.nlm.nih.gov/38337381/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9187217/
• https://academic.oup.com/jcem/issue/107/8
• https://onlinelibrary.wiley.com/doi/10.1002/dmrr.3667
• https://www.healthline.com/health/how-to-sleep-8-hours-in-4-hours#is-it-healthy
• https://www.dhirubhai.net/posts/docmranney_longevity-docm-health-activity-7191234832599863296-BokU?utm_source=share&utm_medium=member_desktop
• https://www.dhirubhai.net/posts/docmranney_longevityapp-healthapp-mito-activity-7191642624414334976-tsEr?utm_source=share&utm_medium=member_desktop
• https://sleepdoctor.com/sleep-environment/#:~:text=The%20best%20sleep%20environment%20is,get%20a%20better%20night's%20rest