Insomnia identified as a new risk factor for type 2 diabetes in new study which also confirms many other risk and protective factors

September 08, 2020

*Note: For a full graphic illustration figure of the results that you may use in your stories, see: https://diabetologia-journal.org/wp-content/uploads/2020/08/Yuan-GA.pdf

A new 'global atlas' study published in Diabetologia (the journal of the European Association for the Study of Diabetes [EASD]) is the first to identify insomnia as a risk factor associated with increased risk of developing type 2 diabetes (T2D). The study identifies 34 risk factors that are thought to increase (19) or decrease risk (15), as well as a further 21 'suggestive' risk factors where evidence was not quite as strong.

The study by Associate Professor Susanna Larsson and by Shuai Yuan of the Karolinska Institutet, Stockholm, Sweden, used a technique called 'Mendelian Randomisation' (MR), which uses genetic variation as a natural experiment to investigate the causal relations between potentially modifiable risk factors and health outcomes in observational data. MR is less likely to be affected by confounding or reverse causation than observational studies.

To identify possible risk factors for T2D, the authors conducted a review of meta-analyses and review articles in the PubMed database and found 1,360 relevant articles. They found a total of 97 risk factors that could be investigated using the MR method. For the study population, they used summary-level data from the DIAbetes Genetics Replication And Meta-analysis consortium (74,124 type 2 diabetes cases and 824,006 controls of European ancestry). The team then checked that these potential causal associations could be replicated in a separate independent population, using the FinnGen consortium (11,006 type 2 diabetes cases and 82,655 controls of European ancestry).

They found evidence of causal associations between 34 exposures (19 risk factors and 15 protective factors) and T2D. Insomnia was identified as a novel risk factor, with people with insomnia being 17% more likely to develop T2D than those without.

The other 18 risk factors for T2D were depression, systolic blood pressure, starting smoking, lifetime smoking, coffee (caffeine) consumption, blood plasma levels of the amino acids isoleucine, valine and leucine, liver enzyme alanine aminotransferase (a sign of liver function), childhood and adulthood body mass index (BMI), body fat percentage, visceral (internal) fat mass, resting heart rate, and blood plasma levels of four fatty acids.

The 15 exposures associated with a decreased risk of type 2 diabetes were plasma alanine (an amino acid), high density lipoprotein (good cholesterol) and total cholesterol, age at beginning puberty in women (menarche), testosterone levels, sex hormone binding globulin levels (adjusted for BMI), birthweight, adulthood height, lean body mass (for women), four plasma fatty acids, circulating vitamin D and years of education.

After adjusting for adulthood BMI, 8 risk factors remained statistically significantly associated with T2D risk, suggesting they are independent of body weight (see figure 2 full paper). Insomnia remained as one of these factors, however the increased risk for those with insomnia compared to those without fell from 17% to 7% after adjustment for BMI, indicating that part of the effect of insomnia on T2D risk is mediated by BMI. Systolic blood pressure, lifetime smoking and levels of liver enzyme remained as risk factors (positively associated with T2D). Increasing total cholesterol, good cholesterol, testosterone levels and sex hormone levels remained as protective factors (inversely associated with T2D) after adjustment.

Among the further 21 'suggestive' causal factors for type 2 diabetes (where the evidence was weaker than for the other factors above) were alcohol consumption, breakfast skipping, daytime napping, short sleep, urinary sodium (salt) levels, and certain amino acids and inflammatory factors.

The authors conclude: "Our study confirmed several previously established risk factors and identified novel potential risk factors for type 2 diabetes using the latest summary-level data. Findings should inform public health policies for the primary prevention of type 2 diabetes. Prevention strategies should be constructed from multiple perspectives, such as lowering obesity and smoking rates and levels, and improving mental health, sleep quality, educational level and birthweight."
-end-


Diabetologia

Related Diabetes Articles from Brightsurf:

New diabetes medication reduced heart event risk in those with diabetes and kidney disease
Sotagliflozin - a type of medication known as an SGLT2 inhibitor primarily prescribed for Type 2 diabetes - reduces the risk of adverse cardiovascular events for patients with diabetes and kidney disease.

Diabetes drug boosts survival in patients with type 2 diabetes and COVID-19 pneumonia
Sitagliptin, a drug to lower blood sugar in type 2 diabetes, also improves survival in diabetic patients hospitalized with COVID-19, suggests a multicenter observational study in Italy.

Making sense of diabetes
Throughout her 38-year nursing career, Laurel Despins has progressed from a bedside nurse to a clinical nurse specialist and has worked in medical, surgical and cardiac intensive care units.

Helping teens with type 1 diabetes improve diabetes control with MyDiaText
Adolescence is a difficult period of development, made more complex for those with Type 1 diabetes mellitus (T1DM).

Diabetes-in-a-dish model uncovers new insights into the cause of type 2 diabetes
Researchers have developed a novel 'disease-in-a-dish' model to study the basic molecular factors that lead to the development of type 2 diabetes, uncovering the potential existence of major signaling defects both inside and outside of the classical insulin signaling cascade, and providing new perspectives on the mechanisms behind insulin resistance in type 2 diabetes and possibly opportunities for the development of novel therapeutics for the disease.

Tele-diabetes to manage new-onset diabetes during COVID-19 pandemic
Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic.

Genetic profile may predict type 2 diabetes risk among women with gestational diabetes
Women who go on to develop type 2 diabetes after having gestational, or pregnancy-related, diabetes are more likely to have particular genetic profiles, suggests an analysis by researchers at the National Institutes of Health and other institutions.

Maternal gestational diabetes linked to diabetes in children
Children and youth of mothers who had gestational diabetes during pregnancy are at increased risk of diabetes themselves, according to new research published in CMAJ (Canadian Medical Association Journal).

Two diabetes medications don't slow progression of type 2 diabetes in youth
In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body's ability to make insulin, according to results published online June 25 in Diabetes Care.

People with diabetes visit the dentist less frequently despite link between diabetes, oral health
Adults with diabetes are less likely to visit the dentist than people with prediabetes or without diabetes, finds a new study led by researchers at NYU Rory Meyers College of Nursing and East Carolina University's Brody School of Medicine.

Read More: Diabetes News and Diabetes Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.