Précédent|Prochain

Correlation between insomnia, gastrointestinal symptoms, and glycated hemoglobin in patients with type 2 diabetes: a cross-sectional study based on the co-management platform of three disciplines of diabetes

  • role： First author第一作者
  • Affiliation：

    The First Affiliated Hospital of Xiamen University, Xiamen 361001, China

    Integrated Traditional Chinese and Western Medicine Center, School of Medicine, Xiamen University, Xiamen 361001, China

  • Introduction：李博，男，博士，主治医师
LI Bo12,  
  • Affiliation：

    Xiamen Hospital of Traditional Chinese Medicine, Xiamen 361006, China

YUAN Qi3,  
  • Affiliation：

    Jinjiang Traditional Chinese Medicine Hospital, Quanzhou 362201, China

WANG Yongfa4,  
  • Affiliation：

    The Fifth Hospital of Xiamen, Xiamen 361101, China

FENG Youjian5,  
  • Affiliation：

    Anxi Traditional Chinese Medicine Hospital, Quanzhou 362499, China

WANG Guimiao6,  
  • Affiliation：

    Nan′an Traditional Chinese Medicine Hospital, Quanzhou 362307, China

NIAN Weidong7,  
  • Affiliation：

    Xiamen Hospital of Traditional Chinese Medicine, Xiamen 361006, China

ZHOU Yi3,  
  • Affiliation：

    Xiamen Hospital of Traditional Chinese Medicine, Xiamen 361006, China

HU Tianchi3,  
  • Affiliation：

    Xiamen Hospital of Traditional Chinese Medicine, Xiamen 361006, China

MA Sisi3,  
  • Affiliation：

    The First Affiliated Hospital of Xiamen University, Xiamen 361001, China

    Integrated Traditional Chinese and Western Medicine Center, School of Medicine, Xiamen University, Xiamen 361001, China

JIA Liyan12,  
  • Affiliation：

    The First Affiliated Hospital of Xiamen University, Xiamen 361001, China

    Integrated Traditional Chinese and Western Medicine Center, School of Medicine, Xiamen University, Xiamen 361001, China

ZHANG Zhihai12,  
  • Affiliation：

    The First Affiliated Hospital of Xiamen University, Xiamen 361001, China

    Integrated Traditional Chinese and Western Medicine Center, School of Medicine, Xiamen University, Xiamen 361001, China

LI Jin12,  
  • Affiliation：

    The First Affiliated Hospital of Xiamen University, Xiamen 361001, China

    Integrated Traditional Chinese and Western Medicine Center, School of Medicine, Xiamen University, Xiamen 361001, China

YAN Bing12,  
  • Affiliation：

    The First Affiliated Hospital of Xiamen University, Xiamen 361001, China

    Integrated Traditional Chinese and Western Medicine Center, School of Medicine, Xiamen University, Xiamen 361001, China

ZHAO Nengjiang12,  
  • role： Corresponding author通信作者
  • Affiliation：

    The First Affiliated Hospital of Xiamen University, Xiamen 361001, China

    Integrated Traditional Chinese and Western Medicine Center, School of Medicine, Xiamen University, Xiamen 361001, China

  • Email：xmyangshuyu@xmu.edu.cn
  • Introduction：Prof. YANG Shuyu, Ph.D., Chief Physician, Doctoral Supervisor.The First Affiliated Hospital of Xiamen University, Xiamen University, No.55, Zhenhai Road, Siming District, Xiamen 361001. E-mail: xmyangshuyu@xmu.edu.cn
YANG Shuyu12*

résumé

ObjectiveTo investigate the relationship between insomnia, gastrointestinal symptoms, and glycosylated hemoglobin (HbA1c) levels in individuals diagnosed with type 2 diabetes mellitus (T2DM), as well as the related influencing factors.MethodsA total of 910 T2DM patients treated in our multicenter from January 2022 to December 2022 were enrolled in this study. General information (gender, age, smoking and drinking history, exercise, course of disease, treatment and complications), HbA1c, Athens Insomnia Scale(AIS) scores and Gastrointestinal Symptoms Rating Scale(GSRS) scores of patients were collected. The differences of sleep and gastrointestinal symptoms between groups were analyzed, and the correlation between the differences and HbA1c was analyzed. Furthermore, the risk factors for non-standard HbA1c were analyzed.ResultsThe AIS score and GSRS score in the HbA1c control group were less than those in the non-standard group (P<0.01). Insomnia was reported by 37.0% of T2DM patients, and the HbA1c level in the insomnia group was significantly higher than that in the non-insomnia group (10.00%±2.38% vs. 8.26%±1.73%, P<0.01). Gastrointestinal symptoms were present in 57.5% of T2DM patients, and the HbA1c levels in the group with gastrointestinal symptoms were significantly higher than those in the group without gastrointestinal symptoms (9.26%±2.23% vs. 8.43%± 1.98%, P<0.01). Furthermore, 26.3% of T2DM patients experienced both insomnia and gastrointestinal symptoms. Remarkably, the HbA1c levels in the group with both insomnia and gastrointestinal symptoms were significantly higher than those in the group without either condition (10.18%±2.44% vs. 8.45%±1.86%, P<0.01). Correlation analysis demonstrated a significant association between sleep quality, gastrointestinal function, and HbA1c levels (P<0.01). The logistic regression analysis result revealed that age, GSRS score, AIS score, and the presence of insomnia combined with gastrointestinal symptoms were independent risk factors for predicting HbA1c≥6.5% (P<0.01). Having both insomnia and gastrointestinal symptoms concurrently was the strongest risk factor for substandard HbA1c control, and the risk of blood sugar control may increase about 5 times when both appear together.ConclusionInsomnia and gastrointestinal symptoms are common comorbidities in T2DM patients, showing a cross-interfering relationship, and they appear together with poor blood sugar control, interact causally, and amplify each other.

mots-clés

type 2 diabetes;insomnia;gastrointestinal symptoms;glycosylated hemoglobin;co-management platform of three disciplines of diabetes

References

  1. [1].
    P XUE, X TAN, C BENEDICT. Association of socioeconomic deprivation with sleep health in patients with type 2 diabetes[J]. Diabetes Obes Metab, 2023, 25(10): 2937-2943.
  2. [2].
    Y SONG, ZG CHANG, C SONG, et al. Association of sleep quality, its change and sleep duration with the risk of type 2 diabetes mellitus: findings from the English longitudinal study of ageing[J]. Diabetes Metab Res Rev, 2023, 39(6): e3669.
  3. [3].
    JH JANG, W KIM, JS MOON, et al. Association between sleep duration and incident diabetes mellitus in healthy subjects: a 14－year longitudinal cohort study[J]. J Clin Med, 2023, 12(8): 2899.
  4. [4].
    C HOFFMANN, PE SCHWARZ, CS MANTZOROS, et al. Circulating levels of gastrointestinal hormones in prediabetes reversing to normoglycemia or progressing to diabetes in a year-a cross-sectional and prospective analysis[J]. Diabetes Res Clin Pract, 2023, 199: 110636.
  5. [5].
    SA DIXON, S MISHRA, KB DIETSCHE, et al. The effects of prebiotics on gastrointestinal side effects of metformin in youth: a pilot randomized control trial in youth-onset type 2 diabetes[J]. Front Endocrinol, 2023, 14: 1125187.
  6. [6].
    HL YUANG, YX ZHANG, DZ PENG, et al. Development and validation of a risk nomogram model for predicting constipation in patients with type 2 diabetes mellitus[J].Diabetes Metab Syndr Obes, 2023, 16: 1109-1120.
  7. [7].
    杨叔禹. 糖尿病“三师共管”诊疗模式的探索与实践[J]. 中华糖尿病杂志，2023, 15(6): 479-483.
  8. [8].
    XL SHI, J HE, MZ LIN, et al. Comparative effectiveness of team-based care with and without a clinical decision support system for diabetes management: a cluster randomized trial[J]. Ann Intern Med, 2023, 176(1): 49-58.
  9. [9].
    中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2020年版)[J].中华糖尿病杂志，2021，13(4):315-409.
  10. [10].
    CR SOLDATOS, DG DIKEOS, TJ PAPARRIGOPOULOS. Athens Insomnia Scale: validation of an instrument based on ICD－10 criteria[J]. J Psychosom Res, 2000，48(6): 555-560.
  11. [11].
    J SVEDLUND, I SJÖDIN, G DOTEVALL. GSRS—a clinical rating scale for gastrointestinal symptoms in patients with irritable bowel syndrome and peptic ulcer disease[J].Dig Dis Sci, 1988, 33(2): 129-134.
  12. [12].
    占娜，贾丽燕，李博，等. 基于美国糖尿病学会指南“以患者为中心”与中医学“以人为本”对糖尿病综合诊疗的思考[J]. 中华糖尿病杂志，2023, 15(6): 564-568.
  13. [13].
    SK SCHÄFER, KJ WEIDNER, J HOPPNER, et al. Design and validation of a German version of the GSRS-IBS- an analysis of its psychometric quality and factorial structure[J]. BMC Gastroenterol, 2017, 17(1): 139.
  14. [14].
    J HENSON, A COVENANT, AP HALL, et al. Waking up to the importance of sleep in type 2 diabetes management: a narrative review[J]. Diabetes Care, 2024, 47(3): 331-343.
  15. [15].
    MJ DAVIES, VR ARODA, BS COLLINS, et al. Management of hyperglycemia in type 2 diabetes, 2022. a consensus report by the American diabetes association (ADA) and the European association for the study of diabetes (EASD)[J]. Diabetes Care, 2022, 45(11): 2753-2786.
  16. [16].
    段卉妍，黄文雅，黄晓飞. 失眠与2型糖尿病相关性的研究进展[J]. 中国糖尿病杂志，2022, 30(1): 70-72.
  17. [17].
    MM DERMANOWSKI, A WICHNIAK, A HEJDUK, et al. Behavioural parameters of circadian rhythm are not correlated with dim light melatonin onset: an observational study on healthy volunteers[J]. J Clin Med, 2023, 12(24): 7757.
  18. [18].
    XF MAO, F ZHANG, C WEI, et al. The impact of insomnia on anxiety and depression: a longitudinal study of non-clinical young Chinese adult males[J]. BMC Psychiatry, 2023, 23(1): 360.
  19. [19].
    DJ STENVERS, FAJL SCHEER, P SCHRAUWEN, et al. Circadian clocks and insulin resistance[J]. Nat Rev Endocrinol, 2019, 15(2): 75-89.
  20. [20].
    C SALISBURY, MS MAN, P BOWER, et al. Management of multimorbidity using a patient-centred care model: a pragmatic cluster-randomised trial of the 3D approach[J]. Lancet, 2018, 392(10141): 41-50.
  21. [21].
    DJ GOTTLIEB, NM PUNJABI, AB NEWMAN, et al. Association of sleep time with diabetes mellitus and impaired glucose tolerance[J]. Arch Intern Med, 2005, 165(8): 863-867.
  22. [22].
    ZH LI, PD ZHANG, Q CHEN, et al. Association of sleep and circadian patterns and genetic risk with incident type 2 diabetes: a large prospective population-based cohort study[J]. Eur J Endocrinol, 2021，185(5): 765-774.
  23. [23].
    G FAGHERAZZI, G GUSTO, B BALKAU, et al. Functional gastrointestinal disorders and incidence of type 2 diabetes: evidence from the E3N-EPIC cohort study[J].Diabetes Metab，2016，42(3):178-183.
  24. [24].
    J CHEN, S YUAN, T FU, et al. Gastrointestinal consequences of type 2 diabetes mellitus and impaired glycemic homeostasis: a Mendelian randomization study[J]. Diabetes Care, 2023, 46(4): 828-835.
  25. [25].
    田佳星，李敏，仝小林. 过食肥甘与糖尿病关系的历史沿革[J].中医杂志，2018, 59(12): 1002-1005.
  26. [26].
    柳燕，方朝晖．从脾论治糖耐量减低的临床意义[J].中医杂志，2013, 54(12): 1007-1009.
  27. [27].
    L REN, YX CHENG, F QIN. Herbal formula Gegen-Qinlian decoction for type 2 diabetes mellitus: a meta-analysis of randomized controlled trials[J]. Evid Based Complement Alternat Med, 2020, 2020: 3907920.
  28. [28].
    HY LI, LH ZHAO, B ZHANG, et al. A network pharmacology approach to determine active compounds and action mechanisms of Ge-Gen-Qin-Lian decoction for treatment of type 2 diabetes[J]. Evid Based Complement Alternat Med, 2014, 2014: 495840.
  29. [29].
    周琦，朱向东，仝小林，等. 葛根芩连汤对2型糖尿病模型大鼠胰岛细胞IRS－2/PI3K-Akt通路的影响[J]. 中医杂志，2018, 59(11): 973-977.
  30. [30].
    C CELLIER, G BOUMA, T VAN GILS, et al. Safety and efficacy of AMG 714 in patients with type 2 refractory coeliac disease: a phase 2a, randomised, double-blind, placebo-controlled, parallel-group study[J]. Lancet Gastroenterol Hepatol, 2019, 4(12): 960-970.
  31. [31].
    JA TYE-DIN, AJM DAVESON, G GOEL, et al. Efficacy and safety of gluten peptide-based antigen-specific immunotherapy (Nexvax2) in adults with coeliac disease after bolus exposure to gluten (RESET CeD): an interim analysis of a terminated randomised, double-blind, placebo-controlled phase 2 study[J]. Lancet Gastroenterol Hepatol, 2023, 8(5): 446-457.
  32. [32].
    KA DYAR, D LUTTER, A ARTATI, et al. Atlas of circadian metabolism reveals system-wide coordination and communication between clocks[J]. Cell, 2018, 174(6): 1571-1585.
  33. [33].
    周艺，杨叔禹，柯鸿飞，等．从改善症状入手探析糖尿病的治疗思路与方法[J]. 中医杂志，2024, 65(5): 464-468.

Lire l'article complet

The above content is generated by Large Model Translation. The translated content is for reference only. We do not assume any commercial or legal responsibilty for any consequences arising from the use of our website