| ObjectiveTo investigate relationship between length of sleep and incidence risk of type 2diabetes and to analyze the dose-response relationship between length of sleep and incidence risk of type 2 diabetes,and to provide a basis for the prevention of type 2diabetes and guidance for a healthy life style.MethodsDatabases including Pubmed,Web of Science,CNKI,Wangfang were searched for relevant studies regarding the relationship between length of sleep and incidence risk of type 2 diabetes on september 22,2015.The literature was screened and the quality of literature was evaluated,The relationship between sleep duration and incidence risk of type 2 diabetes was analyzed by Stata software's metan command.The heterogeneity test was performed by Q test and I2 value,the source of heterogeneity was was analyzed by subgroup analysis;Egger and Begg test were used If there is a publication bias,the nonparametric clipping methodis used to estimate the influence of publication bias on the results of the study;The sensitivity of the result is analyzed by sensitivity analysis;The dose-response relationship between sleep duration and type 2 diabetes mellitus was assessed by restrictive cubic spline(RCS)method.ResultsA total of 14 studies were included in the meta-analysis and the quality of literature evaluation was medium and advanced literature.Meta-analysis showed that the incidence risk of type 2 diabetes group with very short sleep was 36% higher than that of the normal group and the incidence risk of type 2 diabetes group with very long sleep was 23%higher than that of the normal group,the RRs and 95%CI were 1.36(1.23~1.50)and1.23(1.09~1.39),respectively;Subgroup analysis showed that other subgroups increasedthe risk of type 2 diabetes in addition to subgroups of the European group in the very short group;Two types of research,North America,follow-up time of 5 ~ 10 years increased the risk of type 2 diabetes in the very long group.Egger and Begg test showed that there is no publication bias in the very short group,and there was publication bias in the very long group,and then nonparametric clipping method showed that RR and 95%CI was 1.11(1.04~1.18)for the very long group.Sensitivity analysis showed the result was reliable.Dose-response Meta-analysis demonstrated sleep duration and the incidence of type 2 diabetes presented a nonlinear relationship,that was,a U-shaped relationship,(5.5h:RR=1.20,95%CI=1.15~1.25;6h:RR=1.10,95%CI=1.08~1.13;6.5h:RR=1.04,95%CI=1.03~1.05;7.5h:RR=1,95%CI=0.98~1.01;8h:RR=1.02,95%CI=0.99~1.06;8.5h:RR=1.07,95%CI=1.01~1.14;9h:RR=1.14,95%CI=1.04~1.26;9.5h:RR=1.23,95%CI=1.07~1.40).ConclusionsShort and long sleep may be an independent factor of the risk of type 2 diabetes;7~8.4h/night of sleep is unlikely a contributing factor of the risk of type 2 diabetes,but less than 7h/night and more than 8.5h/night of sleep possibly causes an increased risk of type2 diabetes.Therefore,a reasonable length of sleep is beneficial for the prevention of type 2diabetes.Objective To investigate the sleep status of patients with type 2 diabetes and to analyze the impact of sleep duration and sleep quality on glycemic control in patients with type 2diabetes,and to provide the basis for nursing staff to take the corresponding health education..Methods Convenient sampling was used.A total of 200 patients with type 2 diabetes mellitus were enrolled in the Department of Endocrinology,Qingdao a Hospital from August 2016 to November 2016.The questionnaire survey was used to investigate the general information of the patients(demographic data,lifestyle behavior and Disease-related conditions),sleep duration,sleep quality and disease-related clinical biochemical markers.Sleep duration according to the <7h/night,7~8.4h/night,?8.5h/night was investigated,The sleep quality was investigated according to the Pittsburgh Sleep Index Scale(PSQI),and clinical and biochemical indexes were investigated by researchers access to electronic medical records.To understand the sleep status of patients with type 2 diabetes mellitus,compare the sleep quality status with the domestic norm,compare the general data and clinical biochemical indexes of different sleep duration and sleep quality in type 2diabetes mellitus.In order to investigate the sleep status of patients with type 2 diabetes,compare the sleep quality status with the domestic norm,compare the general data and clinical biochemical indexes of different sleep time and sleep quality in type 2diabetes.Inorder to analyze the impact of sleep duration and sleep quality on glycemic control in patients with type 2 diabetes,the relationship of sleep duration,sleep quality and glycemic control was analysed by univariate and multivariate logistic regression analysis.Results1 The sleep status of patients with type 2 diabetes(1)Type 2 diabetes patients had a short sleep duration of 98 cases,accounting for 49%,normal sleep duration was 77 cases,accounting for 38.5%,long sleep time was 25 cases,accounting for 12.5%.The PSQI score was(7.56±2.56)and the incidence of sleep disorder was 64%(PSQI?7).self-rated sleep poor quality was 95 cases,accounting for47.5%;low sleep efficiency was 21 cases,accounting for 10.5% Completely normal daytime function only was 12 cases,accounting for 6%;self-reported interrupted sleep was 18 cases,accounting for 9%.(2)Compared with the domestic norm,type 2 diabetes patients were significantly higher in sleep quality,sleep latency,sleep disturbance,daytime function and PSQI score(P<0.001).There were differences in smoking,FPB,2h PB and Hb A1 c levels in different sleep duration groups(P<0.05).The number of chronic complications,FPB,2h PB and Hb A1 c in the sleep disorder group were significantly higher than those in the normal sleep group(P<0.05),and the difference between the two groups was statistically significant(P?0.05).2 Relationship between glycemic control and PSQI score in type 2 diabetic patients Compared with patients having good glycemic control,the patients having poor glycemic control had a significantly higher score on the sleep time,sleep disorder,daytime function and PSQI score(P<0.01),and had no significant difference between the other factors(P?0.05).3 The impact of sleep duration and sleep quality on glycemic control in patients with type2 diabetes(1)The impact of sleep duration on blood glucose in patients with type 2 diabetes<7h/night and ?5.5h/night of sleep was positively correlated with Hb A1c?7,and the OR and 95%CI were 8.76(3.39~22.60)and 6.57(1.44~29.98),respectively.After adjustment of the confounding factors,the results showed less than 7h/night of sleep was positively correlated with Hb A1c?7,OR and 95%CI was 20.40(3.38~124.16),but?8.5h/night of sleep and the correlation between Hb A1c?7 was weakened,OR and 95%CI was 4.94(0.54~45.29).(2)The impact of sleep quality on blood glucose in patients with type 2 diabetes Sleep time,sleep disorder and daytime function were positively correlated with Hb A1c?7,and the OR and 95%CI were 2.71(1.16~6.33),6.87(2.40~19.64),2.38(1.37~4.15),respectively.After adjustment of the confounding factors,Sleep duration,sleep disorder and daytime function were positively correlated with Hb A1c?7,and the OR and 95%CI were 5.82(1.20~28.28),5.62(1.15~27.57)and 2.86(1.08~7.60),respectively.Conclusions Sleep disorders are prevalent in patients with T2 DM.Short sleep duration and poor sleep qulity possibly cause an increased risk of poor glycemic control. |
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