ESPE Abstracts

Background: Poor glycemic control in type 1 diabetes (T1D) is linked to cardiovascular complications. Sleep duration and quality have been shown to be related to glycemic control, glucose variability, and endothelial dysfunction in adults with T1D. This study aimed to evaluate the relationship between sleep characteristics, glycemic control, glucose patterns, and endothelial function in adolescents and young adults with T1D.

Method: Thirty subjects with T1D for at least one year, aged 13-25 years, and without chronic complications were enrolled (mean age 18.7±3.4 years, HbA1C 7.6±1.3%). Glycemic patterns and glucose variability indices were assessed using a real-time continuous glucose monitoring (CGM). Sleep characteristics were monitored using wrist-worn actigraphy, along with CGM, for 5-7 days. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was completed to assess subjective sleep quality. Flow-mediated dilatation (FMD) was performed to assess endothelial function at the brachial artery.

Results: Reduced FMD was associated with poor sleep quality in T1D subjects without metabolic syndrome (r= 0.426, P= 0.034). Subjects with poor sleep quality (PSQI score > 5) had significantly lower %FMD than in those with PSQI score ≤ 5 (4.6±3.7% vs. 7.6±3%, P= 0.03). HbA1C levels were correlated with sleep efficiency (r= -0.399, P= 0.039) and sleep duration variability (r= 0.395, P= 0.042). Variability in bedtime and mid-sleep time were associated with insulin resistance, as determined by low estimated glucose disposable rate (eGDR) (r= -0.545, P= 0.003; r= -0.467, P= 0.014).

Conclusion: Sleep efficiency and variability are associated with glycemic control. Sleep quality is linked to endothelial function in adolescents and young adults with T1D. These findings highlight the importance of promoting healthy sleep habits in the management of T1D across the lifespan.