Not Sleeping Well? It Could Be Affecting Your Diabetes Control

Poor sleep is associated with high levels of insulin resistance and difficulty controlling diabetes in people who have the condition, according to new research from the University of Chicago Medical Center.


Previous studies investigating the links between sleep and diabetes have indicated that short sleep duration increases levels of ghrelin, an appetite-stimulating hormone, can decrease glucose tolerance and stimulate production of the stress hormone cortisol, and may triple a person’s risk of developing impaired fasting glucose (IFG, a condition that leads to Type 2 diabetes and heart disease). Additionally, people who have sleep apnea are more than twice as likely as those who don’t to have diabetes, and 50% of men with Type 2 diabetes have sleep apnea.

To determine whether sleep duration and quality are associated with fasting glucose or insulin levels or levels of insulin resistance (a condition in which the body needs extra insulin to maintain normal blood glucose levels), researchers followed 40 people with diabetes and 115 people without diabetes for six nights. The participants indicated whether they had any sleep disturbances, such as insomnia, snoring, or sleep apnea, and had their blood glucose and insulin levels checked. Over the course of the study period, the participants wore activity monitors on their wrists nightly to measure wrist movements during the night. Poor sleep was determined based both on the readings from the wrist monitors (frequent wrist movement was taken as a sign of poor sleep) as well as reports from the participants that they had a hard time falling asleep or that they woke up during the night.

In people without diabetes, there was no association between poor sleep and fasting glucose or insulin levels or insulin resistance. In those with diabetes, however, the researchers found that poor sleepers had 23% higher morning blood glucose levels and 48% higher blood insulin levels. Using these numbers, it was estimated that people with diabetes who slept poorly had 82% higher insulin resistance than people with diabetes who slept well.

Kristen Knutson, PhD, lead author of the study, noted that “Poor sleep quality in people with diabetes was associated with worse control of their blood glucose levels… People who have a hard time controlling their blood glucose levels have a greater risk of complications. They have a reduced quality of life. And, they have a reduced life expectancy.” And Eve Van Cauter, PhD, one of the study’s co-authors, stated that “This [study] suggests that improving sleep quality in diabetics would have a similar beneficial effect as the most commonly used anti-diabetes drugs.”

These are all good reasons to make getting more sleep a priority, but if you’re dealing with insomnia, this advice is of course easier said than done. For tips on getting a restful night’s sleep, check out “Getting the Sleep You Need” and “Getting Back to Sleep,” both by nurse David Spero.

The next step for the researchers is to study whether treating unrefreshing sleep can improve the quality of life and long-term health outcomes for people with diabetes. Also necessary is determining whether the poor sleep leads to the insulin resistance or vice-versa.

To learn more about the research, read the article “Insomnia Linked to High Insulin Resistance in Diabetics” or see the study’s abstract in Diabetes Care.

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  • Laurie

    I am relatively new to Type 2 Diabetes and my problem seems to be too much sleep. I’m exhausted most of the time and I sometimes fall asleep for 11 or 12 hours. I can’t seem to stay awake.

  • still too fat

    For a person who has difficulty getting quality sleep due to chronic pain issues; any advice on getting help with pain control when doctors are scared to death to prescribe pain or sleep meds for fear that they will be labeled “pill-pushers” or investigated for writing too many scripts for “controlled substances”?

  • Diane Fennell

    Hi Laurie and still too fat,

    Thank you both for your comments.

    Laurie, I’m not a doctor and can’t make a diagnosis, but you might want to speak with your health-care provider about whether you have any symptoms of sleep apnea, which has been shown to have associations with Type 2 diabetes. In this condition, people stop breathing for 10 seconds or more during the night, sometimes hundreds of times. This causes disruptions in sleep and, accordingly, leads to fatigue. You can learn more about it in this article. Again, I’m not suggesting that you have sleep apnea, but it might be something worth investigating. In either case, be sure to let your health-care provider know how you’re feeling.

    Still too fat, you might be interested in the article “Managing Chronic Pain,” by nurse David Spero.

    Diane Fennell
    Web Editor

  • Steve

    I was dianosed with sleep apnea in 1996, but as any of my bunkmates at the Fire Department would tell you, I had a horrible snoring problem since the late ’70s. I had a quadruple bypass in 1995; I was diagnosed with Type II diabetes in 1997. From my experience, a CPAP is the best way to go to reduce chronic fatigue, vastly improve sleep quality, and the very task of starting it up each night is an almost Pavlovian measure to assure I’ll be asleep with 60 seconds, sleeping through the night. With the aid of the CPAP, careful diet, exercise (10,000+ steps per day) and insulin, I am in good control of my blood glucose, with quarterly readings around 6.5. I’m not a fanatic, but I am careful in keeping myself under control – yes I have a huge piece of carrot cake or a couple of chocolate truffles once in awhile, but I make an entree salad to compensate. It’s a 24/7/365 lifestyle challenge.

  • still too fat


    Thank you for your kind response, however my question was not so much about how to manage my own pain as to how to deal with a medical community that feels forced to under medicate patients in pain due to the inquisitionesque fear generated by an over-zealous and politically motivated “war on drugs.”

    For example, I had a doctor tell me that he would like to write a scrip for pain meds, but every time he did, it was reported to the FBI, and if he wrote more than the “approved” number, he would be investigated as a potential drug dealer. As a result, he was recommending Ibuprofen to people he felt really needed opiates. He was emotionally distressed, because he felt he was letting his patients suffer needlessly for fear of losing his medical license, or worse, going to jail.