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Improvement of glycemic control by treatment for insomnia with suvorexant in type 2 diabetes mellitus
- Source :
- Journal of Clinical & Translational Endocrinology, Journal of Clinical & Translational Endocrinology, Vol 15, Iss, Pp 37-44 (2019)
- Publication Year :
- 2018
- Publisher :
- Elsevier, 2018.
-
Abstract
- Introduction: 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. Materials and methods: 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. Results: 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. Conclusions: 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. Keywords: Type 2 diabetes mellitus, Therapy for insomnia, Glycemic control, Insulin resistance, Dawn phenomenon, Autonomic nervous function
- Subjects :
- endocrine system diseases
Endocrinology, Diabetes and Metabolism
BMI, body mass index
REM, rapid eye movement
Dawn phenomenon
lcsh:Diseases of the endocrine glands. Clinical endocrinology
AUC, area under the curve
0302 clinical medicine
Endocrinology
Therapy for insomnia
Glycemic control
Insomnia
030212 general & internal medicine
HR, heart rate
CVR-R, coefficient of variation of RR intervals
SAS, Sleep Apnea Syndrome
Anesthesia
DSM-5, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition
medicine.symptom
EEG, electroencephalography
IRI, immunoreactive insulin
Research Paper
AHI, Apnea–Hypopnea Index
PSQI, Pittsburgh Sleep Quality Index
HOMA-IR, homeostasis model assessment of insulin resistance
030209 endocrinology & metabolism
eGFR, estimated glomerular filtration ratio
Carbohydrate metabolism
HRV, heart rate variability
03 medical and health sciences
Insulin resistance
Type 2 diabetes mellitus
medicine
Autonomic nervous function
CGM, continuous glucose monitoring
bpm, beats per minute
IQR, interquartile range
Glycemic
SDNN, standard deviation of the NN (i.e., R-R) intervals
lcsh:RC648-665
business.industry
Suvorexant
Type 2 Diabetes Mellitus
nutritional and metabolic diseases
CPR, C-peptide immunoreactivity
T2DM, type 2 diabetes mellitus
medicine.disease
Orexin
business
SD, standard deviation
HbA1c, glycated hemoglobin A1c
Subjects
Details
- Language :
- English
- ISSN :
- 22146237
- Volume :
- 15
- Database :
- OpenAIRE
- Journal :
- Journal of Clinical & Translational Endocrinology
- Accession number :
- edsair.doi.dedup.....a9708fc2e4e75405adff09252f1b29cd