The effects of cognitive behavioral therapy for insomnia in people with type 2 diabetes mellitus, pilot RCT part II: diabetes health outcomes

Autor: Aqeel M Alenazi, Patricia M Kluding, Catherine F. Siengsukon, Mohammed Alshehri, Jason Rucker, John M. Miles, Milind A. Phadnis, Shaima Alothman
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Adult
Male
medicine.medical_specialty
Insomnia
Endocrinology
Diabetes and Metabolism
medicine.medical_treatment
Pilot Projects
030209 endocrinology & metabolism
Type 2 diabetes
Cognitive behavioral therapy for insomnia
behavioral disciplines and activities
lcsh:Diseases of the endocrine glands. Clinical endocrinology
law.invention
03 medical and health sciences
0302 clinical medicine
Glycemic control
Randomized controlled trial
law
Sleep Initiation and Maintenance Disorders
Diabetes mellitus
Outcome Assessment
Health Care
mental disorders
medicine
Humans
030212 general & internal medicine
Fatigue
Aged
Glycemic
Glycated Hemoglobin
lcsh:RC648-665
business.industry
Diabetes
Type 2 Diabetes Mellitus
General Medicine
Middle Aged
medicine.disease
Cognitive behavioral therapy
Clinical trial
Treatment Outcome
Diabetes Mellitus
Type 2
Physical therapy
Female
Self-care
business
Research Article
Zdroj: BMC Endocrine Disorders, Vol 20, Iss 1, Pp 1-9 (2020)
BMC Endocrine Disorders
ISSN: 1472-6823
DOI: 10.1186/s12902-020-00612-6
Popis: Background Previous studies have shown the negative impact of sleep disturbances, specifically insomnia symptoms, on glucose metabolism for people with type 2 diabetes (T2D). People with insomnia symptoms are at risk of poor glycemic control and suboptimal diabetes self-care behavior (DSCB). Investigating the impact of a safe and effective intervention for individuals with T2D and insomnia symptoms on diabetes’ health outcomes is needed. Therefore, the aim of this exploratory study is to examine the effects of Cognitive Behavioral Therapy for Insomnia (CBT-I) on glycemic control, DSCB, and fatigue. Methods Twenty-eight participants with T2D and insomnia symptoms, after passing an eligibility criteria at a medical research center, were randomly assigned to CBT-I (n = 14) or Health Education (HE; n = 14). The CBT-I and HE groups received 6 weekly one-hour sessions. This Randomized Controlled Trial (RCT) used a non-inferiority framework to test the effectiveness of CBT-I. Validated assessments were administered at baseline and post-intervention to assess glycemic control, DSCB, and fatigue. A Wilcoxon signed-rank test was utilized to compare within-group changes from baseline to post-intervention. A Mann-Whitney test was utilized to measure the between-group differences. Linear regression was used to assess the association between the blood glucose level and the number of days in the CBT-I group. Results The recruitment duration was from October 2018 to May 2019. A total of 13 participants completed the interventions in each group and are included in the final analysis. No adverse events, because of being a part of this RCT, were reported. CBT-I participants showed significantly greater improvement in glycemic control, DSCB, and fatigue. There was a significant association between the number of days in the CBT-I intervention with the blood glucose level before bedtime (B = -0.56, p = .009) and after awakening in the morning (B = -0.57, p = .007). Conclusions This study demonstrated a clinically meaningful effect of CBT-I on glycemic control in people with T2D and insomnia symptoms. Also, CBT-I positively impacted daytime functioning, including DSCB and fatigue. Future research is needed to investigate the long-term effects of CBT-I on laboratory tests of glycemic control and to understand the underlying mechanisms of any improvements. Trial registration Clinical Trials Registry (NCT03713996). Retrospectively registered on 22 October 2018
Databáze: OpenAIRE
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