Sleep and glycemic control in type 1 diabetes

Objective Our aim in the present study was to elucidate how type 1 diabetes mellitus (T1DM) and sleep parameters interact, which was rarely evaluated up to the moment. Materials and methods Eighteen T1DM subjects without chronic complications, and 9 control subjects, matched for age and BMI, were studied. The following instruments used to evaluate sleep: the Epworth Sleepiness Scale, sleep diaries, actimeters, and polysomnography in a Sleep Lab. Glycemic control in T1DM individuals was evaluated through: A1C, home fingertip glucometer for 10 days (concomitant with the sleep diary and actimeter), and CGM or concomitant with continuous glucose monitoring (during the polysomnography night). Results Comparing with the control group, individuals with diabetes presented more pronounced sleep extension from weekdays to weekends than control subjects (p = 0.0303). Among T1DM, glycemic variability (SD) was positively correlated with sleep latency (r = 0.6525, p = 0.0033); full awakening index and arousal index were positively correlated with A1C (r = 0.6544, p = 0.0081; and r = 0.5680, p = 0.0272, respectively); and mean glycemia values were negatively correlated with sleep quality in T1DM individuals with better glycemic control (mean glycemia < 154 mg/dL). Conclusion Our results support the hypothesis of an interaction between sleep parameters and T1DM, where the glycemic control plays an important role. More studies are needed to unveil the mechanisms behind this interaction, which may allow, in the future, clinicians and educators to consider sleep in the effort of regulating glycemic control. Arch Endocrinol Metab. 2015;59(1):71-8 .

Ontogênese do sistema de temporização: a construção e as reformas dos ritmos biológicos ao longo da vida humana / L'ontogenèse du système de temporisation: sa constrution et les changements de rythmes biologiques au long de la vie humaine / Ontogeny of the timing system: building and reforms of biological rhythms along human life

Nesta revisão apresentamos fatos e comentários sobre a evolução dos sistemas de temporização ("relógios biológicos") na espécie humana. Na Introdução definimos alguns conceitos básicos da Cronobiologia que serão utilizados ao longo do artigo. Nas quatro seções subseqüentes, discutimos fatos marcantes que caracterizam a ritmicidade biológica em distintas etapas da ontogênese: bebês, adolescentes, adultos e idosos. Concluímos o artigo com um convite à reflexão sobre as perspectivas que se abrem com esse novo campo do conhecimento.

In this review we present facts and comments on the evolution of the timing systems ("biological clocks") in humans. In the Introduction we define basic concepts of Chronobiology which will be used along the paper. In the four following sections we discuss landmarks which characterize biological rhythmicity in distinct moments of ontogeny: infants, adolescents, adults and elderly. We close the review with an invitation to consider the perspectives now open in this new area of knowledge.

Cette révision présente certains faits et des commentaires sur l' ontogenèse des systèmes de temporisation (®les horloges biologiques¼) chez l'homme. D´abord, nous présentons quelques défi nitions fondamentales de la Chronobiologie, ce qui nous semble nécessaire à la compréhension du texte suivant. Les quatre sections organisées à la suite abordent des faits remarquables qui caractérisent la rhythmicité biologique au cours de l'ontogenèse chez les bébés, les adolescents, les adultes et les anciens. A la conlusion nous proposons une réflexion sur les perspectives qui s´ouvrent par ce nouveau champ de connaissance.