Tuesday, November 29, 2011

While You Sleep

There's been more research on type 2 diabetes and sleep than on type 1 diabetes and sleep because sleep deprivation causes insulin resistance (and so it's hoped that correcting sleep deprivation will prevent type 2 diabetes).
The research on type 1 diabetics and sleep is generally not about the sleep per se; it's about what happens to us while we're asleep. Why, what happens to us to us when we're asleep? Weellll....

  • All people have less ability to respond to hypoglycemia while asleep- the body does not like to handle it. Furthermore, people who've had type 1 diabetes long enough will not wake up from hypoglycemia, and we're not any easier to wake up while we're hypo (tested by people who woke up diabetics while they were at blood sugars of 99 and blood sugars of 50 to see how easy it was).

  • Despite this, at least a third of type 1 diabetics frequently are hypoglycemic while asleep without ever knowing about it. Studies with CGMs suggest that 7% people with type 1 diabetes are hypoglycemic on any given night.

  • Blood pressure is supposed to go down during sleep. In type 1 diabetics, early autonomic neuropathy causes blood pressure to not change as much as it's supposed to and not having blood pressure fall during sleep is a strong predictor of who will develop kidney problems (stronger predictors are age at diagnosis and A1c). The American Heart Association is recommending Ambulatory Blood Pressure Monitoring for children and adolescents with type 1 diabetes to screen for this issue.

  • The genetic basis for narcolepsy indicates that a gene protective against type 1 diabetes is high risk for narcolepsy; this might mean that narcoleptics (who are at an astronomical risk for type 2 diabetes) are less likely to have type 1 diabetes; flipped it means that type 1 diabetics are at lower risk of narcolepsy.
  • 1 comment:

    j said...

    I am a type 1 diabetic diagnosed 2 years ago at age 44, I am enjoying your site and others like it- I am using a very low carb-ketogenic diet to manage. It is helping alot. Wishing you all the best on your journey-