Improvement of glycemic control by treatment for insomnia with suvorexant in type 2 diabetes mellitus.
AHI, Apnea–Hypopnea Index
AUC, area under the curve
Autonomic nervous function
BMI, body mass index
CGM, continuous glucose monitoring
CPR, C-peptide immunoreactivity
CVR-R, coefficient of variation of RR intervals
DSM-5, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition
Dawn phenomenon
EEG, electroencephalography
Glycemic control
HOMA-IR, homeostasis model assessment of insulin resistance
HR, heart rate
HRV, heart rate variability
HbA1c, glycated hemoglobin A1c
IQR, interquartile range
IRI, immunoreactive insulin
Insulin resistance
PSQI, Pittsburgh Sleep Quality Index
REM, rapid eye movement
SAS, Sleep Apnea Syndrome
SD, standard deviation
SDNN, standard deviation of the NN (i.e., R-R) intervals
T2DM, type 2 diabetes mellitus
Therapy for insomnia
Type 2 diabetes mellitus
bpm, beats per minute
eGFR, estimated glomerular filtration ratio
Journal
Journal of clinical & translational endocrinology
ISSN: 2214-6237
Titre abrégé: J Clin Transl Endocrinol
Pays: Netherlands
ID NLM: 101629335
Informations de publication
Date de publication:
Mar 2019
Mar 2019
Historique:
received:
19
11
2018
revised:
12
12
2018
accepted:
17
12
2018
entrez:
9
1
2019
pubmed:
9
1
2019
medline:
9
1
2019
Statut:
epublish
Résumé
Acute and chronic insomnia can exacerbate type 2 diabetes mellitus (T2DM). We investigated suvorexant (an anti-insomnia drug that targets the orexin system) effects on sleep architecture and glucose metabolism in T2DM patients with insomnia. This 7 day open-label, single-arm, intervention trial included 18 subjects with T2DM and insomnia. After 1 day acclimatization, daily glucose levels, sleep architecture, and autonomic nervous function were evaluated by continuous glucose monitoring (CGM), single-channel electroencephalography, and accelerometry, respectively. Suvorexant treatment for 3 days significantly increased total sleep time and sleep efficiency, with partial suppression of sympathetic nerve activity. CGM-measured 24 h mean glucose level decreased significantly from 157.7 ± 22.9 to 152.3 ± 17.8 mg/dL, especially in the early glucose surge after the midnight nadir (from 28.3 ± 15.0 to 18.2 ± 9.9 mg/dL), and until supper with a significant improvement in homeostasis model assessment of insulin resistance from 4.0 ± 2.8 to 2.9 ± 1.6, respectively. Suvorexant treatment for insomnia of subjects with T2DM significantly improved CGM-measured daily glycemic control, which was associated with changes in sympathomimetic tone and/or improved insulin sensitivity. The amelioration of insomnia may therefore be a target for improving glycemic control in T2DM patients with insomnia.
Identifiants
pubmed: 30619717
doi: 10.1016/j.jcte.2018.12.006
pii: S2214-6237(18)30139-X
pmc: PMC6306692
doi:
Types de publication
Journal Article
Langues
eng
Pagination
37-44Commentaires et corrections
Type : ErratumIn
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