Improvement of glycemic control by treatment for insomnia with suvorexant in type 2 diabetes mellitus
| Autor: | Masaaki Inaba, Masafumi Kurajoh, Shinsuke Yamada, Daichi Miyaoka, Tomoe Hirota, Noriyuki Hayashi, Norikazu Toi, Masanori Emoto, Tomoaki Morioka |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
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 |
| Zdroj: | Journal of Clinical & Translational Endocrinology Journal of Clinical & Translational Endocrinology, Vol 15, Iss, Pp 37-44 (2019) |
| ISSN: | 2214-6237 |
| Popis: | 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 |
| Databáze: | OpenAIRE |
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