Association between sleep duration and HbA1Cin adults among type 2 diabetics under community management / 中华内分泌代谢杂志

ABSTRACT

Objective To explore the relation of sleep duration and control of HbA1Camong type 2 diabetes mellitus ( T2DM) under community management in Huai'an city. Methods There were 9 393 T2DM patients enrolled from Qinghe district and Huai'an district from Huai'an city using multi-stage cluster sampling method. The level of HbA1Cwas categorized as control group (＜7%) and uncontrolled group (≥7%), and sleeping duration was categorized as＜6 h, 6-8 h, and ＞8 h. Non-conditional logistic regression analysis was utilized to analyze the association between sleep duration and control of HbA1C. No confounders were adjusted in logistic regression model 1;and age, sex, and body mass index were adjusted in model 2 and furthermore, in model 3, smoking, drinking, education, duration of diabetes, familial history of diabetes, activity, and medication were adjusted plus variables in model 2. Stratified analyses were also used to explore the association above. Results Subjects with sleep duration＞8 h had a high risk of uncontrolled HbA1Cwhen compared with subjects for sleep duration of 6-8 h with OR＝1.188 ( P＝0.001) and the association were still existed with OR＝1.191 (P＝0.001) after Bonferroni adjusted and adjustment of age, sex, and body mass index. Whereas, with further adjustment of confounders in model 3, the association was vanished. Results of stratified analyses indicated that with Bonferroni adjustment, overweight patients with sleep duration of＜6 h had a lower risk of uncontrolled HbA1Cwith OR＝0.788 and 0.799, respectively, in model 1 and model 2 (both P＜0.05). Meanwhile, patients of female, or age≥60 years, or body mass index＜24 kg/m2, or disease duration≤3.58 years had high risk of uncontrolled HbA1Cwhen sleep duration＞8 h. Conclusion T2DM patients with sleep duration＞8 h were negative for HbA1Ccontrol, and this association was independent of age, sex, and body mass index, but was influenced by the duration of diabetes, activity, medication, familial history of diabetes, smoking, drinking, and education. Sleep duration in patients of female, age≥60 years, body mass index＜24 kg/m2, and short disease duration, should be appropriately adjusted.