Evaluating the Role of Sleep Duration in Managing Glycemic Control in Type 2 Diabetes: A Systematic Review and Meta-Analysis

Abstract

Background: Type 2 diabetes mellitus (T2DM) is one of the most common metabolic disorders that produces a persistent hyperglycemic state due to insulin resistance and β-cell dysfunction. The lifestyle, especially sleep duration, has also become a possible glycemic control modulator. Both insufficient and excessive sleep time have been associated with poor glucose metabolism although the correlation is irregular among the studies. This association is therefore vital in coming up with sound non-pharmacological interventions to enhance glycemic control in T2DM patients. Objectives: This is a systematic review and meta-analysis we conducted to assess the relationship between sleep duration and glycemic control as indicated by glycated hemoglobin (HbA1c) levels in adults with T2DM. Methodology: An electronic search of PubMed, Scopus, Web of Science, and Google Scholar was conducted using a combination of predetermined keywords with the term sleep duration, glycemic control, and type 2 diabetes. Inclusion criteria: Original observational or intervenient studies evaluating connection between sleep duration and glycated hemoglobin (HbA1c) or fasting blood glucose (FBG) in adults with diabetes type 2. Titles, abstracts, and full-text screening, data extraction, and measurement of the quality of the studies in the NewcastleOttawa Scale were independently conducted by two reviewers. A random-effects model was used to compute pooled mean differences in HbA1c between short (<6 h) or long (>9 h) sleepers and normal (6-8 hours) sleepers by meta-analysis. I 2 statistics were used to measure heterogeneity and Egger test was used to determine publication bias. Results: The inclusion criteria were met by six studies that included 14,215 participants. Pooled analysis demonstrated that shorter sleep duration was linked significantly with increased levels of HbA1c than during normal sleep duration (mean difference = 0.21%, 95% CI: 0.14- 0.28, p < 0.001, I 2 = 42%). Sleep duration was also connected with the high level of HbA1c (mean difference = 0.18%, 95% CI: 0.05-0.31, p = 0.007, I 2 = 39%). The general finding was in relation of U shaped whereby short and long sleep were associated with worse glycemic control. According to the test proposed by Egger, there was no considerable publication bias (p = 0.12). Conclusion: Both sleep duration (both long and short) correlates with poor glycemic control in patients with type 2 diabetes presenting the relevance of ensuring that patients with type 2 diabetes receive sufficient sleep duration amongst their measures to control diabetes. Clinicians ought to think of sleep measurement and counseling as an addition to the mainstream diabetes management.