If you want your blood sugar to not exceed the standard, don't doze off during the day and stay away from supper at night!

*Only for medical professionals to read for reference.
Weekly Information Issue No.
244 tells you that in fact, eating and sleeping are the best sugar control! This week’s summary is that diabetic patients sleep too long at night, beware of the increased risk of death! Diabetics love to take naps during the day, beware that blood sugar can't be controlled! Don't be too self-willed to eat supper on night shift, watch out for diabetes to find you! 1 Diabetics sleep too long at night, beware of the increased risk of death! Diabetes is one of the heaviest disease burdens in the world, and it is of great significance to determine the risk factors for the occurrence and development of diabetes
.

Sleep is very important for the health of ordinary people, and this is especially true for diabetic patients
.

The length of sleep is related to the patient's insulin sensitivity, blood sugar status, and the risk of complications.
A recent study published in Diab Metab analyzed the relationship between sleep duration and the risk of death in diabetic patients
.

 Figure 1.
1 The study was published in Diab Metab.
This study from Seoul National University School of Medicine in South Korea used data from the Korean National Health and Nutrition Examination Survey (KNHANES).
A total of 5,930 people with type 2 diabetes and type 2 diabetes were included in the national statistics database.
Participants with death information
.

Type 2 diabetes is defined as fasting blood glucose ≥7.
0 mmol/L, glycosylated hemoglobin (HbA1c) ≥6.
5%, having been diagnosed as diabetes by a doctor, using oral hypoglycemic drugs or injecting insulin
.

These participants were divided into five groups according to the length of sleep.
The groups and proportions were as follows: sleep length per day ≤ 5 hours (21.
1%), 6 hours (23.
8%), 7 hours (24.
3%), 8 hours (21.
3) %) and ≥9 hours (9.
5%)
.

 It turns out that the median length of sleep for patients with type 2 diabetes is 7 hours a day
.

Compared with patients who sleep for 7 hours a day, those who sleep ≤5 hours and ≥9 hours a day are more likely to suffer from hypertension, chronic kidney disease and cardiovascular disease, and those who sleep ≤5 hours a day are more likely to suffer from hypercholesterolemia.
And depression
.

 During a median follow-up of 6.
5 years, a total of 735 (12.
4%) patients died unfortunately, of which 224 patients died of cancer and 175 patients died of cardiovascular disease
.

Compared with patients who sleep 7 hours a day, too little or too much sleep is associated with an increased risk of death (P for quadratic trend = 0.
003).
Sleeping time ≥9 hours per day increases the risk of death by 65% ​​(HR 1.
65, 95%) CI 1.
29-2.
11)
.

Subgroup analysis showed that male (HR 1.
68, 95%CI 1.
22-2.
30) and female (HR 1.
57, 955CI 1.
05-2.
35) diabetic patients who sleep ≥ 9 hours a day have a significant increase in the risk of death
.

 Figure 1.
2 Sleep duration ≥9 hours in diabetic patients is associated with increased risk of death.
Researchers pointed out that too short sleep time may cause insulin resistance, while too long sleep time may be related to impaired sleep quality, lack of physical activity, chronic inflammation, and day and night Rhythm disorders are related, and may also be the result of impaired metabolic status in diabetic patients, which may lead to insulin resistance
.

 REF: Gu KM, Min SH, Cho JY.
Sleep duration and mortality in patients with diabetes: results from the 2007–2015 Korea National Health and Nutrition Examination Survey.
Diab Metab.
2021 Dec 9.
doi: 10.
1016/j.
diabet.
2021.
101312 .
2 Diabetics love to take naps during the day, beware that blood sugar can't be controlled! A meta-analysis of a prospective study that included more than 13,000 diabetic patients showed that compared with people who do not have the habit of taking a nap during the day, people who are accustomed to taking a nap during the day have a 17% increased risk of diabetes! However, the relationship between nap and blood sugar control in diabetic patients is not fully understood.
Only one study involving 2500 patients found that nap increased the risk of poor blood sugar control by 37%
.

Therefore, a recent study published in the journal Diabetes Obes Metab continues to discuss the relationship between the frequency of daytime naps and blood sugar control in diabetic patients
.

 Figure 2.
1 The study was published in Diabetes Obes Metab.
This study from the Sleep Laboratory at Uppsala University in Sweden used data from the British Biobank and involved more than 500,000 participants
.

The study included 12,997 participants with type 2 diabetes
.

Patients were divided into three groups based on the frequency of nap during the day
.

Among them, 35.
0% of the patients never/rarely took a nap; 52.
6% of the patients sometimes took a nap; 12.
4% of the patients usually took a nap
.

In the study, HbA1c level ≥7% was defined as poor blood sugar control
.

Analysis shows that compared with patients who never/rarely take naps, patients who usually take naps every day are more likely to have HbA1c ≥ 7%, and thus are considered poor blood glucose control (OR 1.
166, 95% CI 1.
031-1.
318, p= 0.
014)
.

At the same time, these patients are also more likely to need insulin therapy (OR 1.
331, 95% CI 1.
148-1.
544, p<0.
001)
.

And when receiving insulin therapy, compared with patients who never/rarely take a nap, patients who usually take a nap every day are still more likely to have HbA1c ≥ 7% (OR 1.
324, 95% CI 1.
120-1.
566, p=0.
001 )
.

 Figure 2.
2 Usually naps are related to poor blood sugar control.
Daytime naps are one of the risk factors for diabetes.
Previous studies from China have also shown that middle-aged people without diabetes like naps are related to higher HbA1c levels and insulin resistance
.

This study shows that the usual nap of diabetic patients is related to the increased risk of HbA1c≥7% during insulin treatment
.

 Researchers pointed out that poor blood sugar control is one of the risk factors for neurodegenerative diseases, which may affect patients' sleep habits
.

At the same time, patients who are accustomed to nap during the day exercise less exercise may also be related to poor blood sugar control
.

Therefore, the next research will continue to explore the causal relationship between the two, and analyze the impact of the length of the nap on blood sugar control
.

 REF: Xue P, Tang X, Tan X, Benedict C.
Self-reported regular daytime napping is associated with indicators of poor type 2 diabetes control: a cohort study.
Diabetes Obes Metab.
2021 Dec 9.
doi: 10.
1111/dom.
14619 3.
Don't be too willful to eat supper on night shift, watch out for diabetes to find you! If you're on an overnight shift, you know how painful it is to reverse day and night—do you want to reward yourself with a good evening meal? Since you can't sleep well, of course you have to find supplements for food
.

This approach seems understandable, but a recent study published in Sci Adv still advises you to eat supper not to be too capricious, and beware of diabetes.
Figure 3.
1 Study published in Sci Adv This clinical study from Harvard University Hospital Brigham and Women's Hospital analyzed the impact of eating during the day and night on the health of shift workers
.

The study recruited 19 healthy young participants, including 7 women and 12 men, with an average age of 26.
5 years, an average body mass index (BMI) of 22.
7 kg/m2, and an average HbA1c level of 4.
9% to 5.
4% of the normal range.
Within
.

 During the 14-day study period, participants ate and sleep in strict accordance with the circadian rhythm of the experimental design
.

Before the formal study began, the researchers assessed the participants' normal baseline metabolic status
.

Subsequently, one group of participants imitated a typical night shift life, eating at night and working at night; another group of participants eating during the day and working at night
.

Researchers evaluated the effects of such diet and sleep schedules on participants' circadian rhythm and glucose tolerance
.

Analysis shows that the typical night shift life does mess up the participants' internal and external circadian rhythms, and eating at night can also cause the average blood sugar level to rise
.

Compared with the baseline level, the average blood sugar level of participants who ate at night increased by 6.
4% (95% CI 2.
7% to 10%); while participants who ate during the day did not experience similar confusion in their brains, and the average blood sugar level did not appear.
Significant increase in P value? (95%CI -1.
7%～4.
2%)
.

 Figure 3.
2 The blood sugar level rises when eating at night.
Researchers pointed out that in a typical night shift work, eating at night and working at night seem to be reasonable.
However, eating at night is actually telling the body that the day is here and it’s time to eat; working at night is also telling the body that now that the day is here, get up to work! However, these two kinds of external information contradict the circadian rhythm inside the body, and it is very likely that the body will be confused-it is time to sleep, what are you doing? I don't care, blood sugar is running around! This research shows that eating during the day can alleviate this situation to a certain extent
.

Although going to work at night still violates the body's internal circadian rhythm, at least eating during the day can still maintain the consistency of external information and the body's internal circadian rhythm
.

Although I can't escape the overnight shift, I still have to control myself not to eat midnight snacks and try to maintain my health to the utmost extent even when I have to work the night shift
.

 REF: Chellappa SL, Qian J, et al.
Daytime eating prevents internal circadian misalignment and glucose intolerance in night work.
Sci Adv.
2021 Dec 3;7(49):eabg9910.
doi: 10.
1126/sciadv.
abg9910.