Sleep Duration, Lifestyle Intervention, and Incidence of Type 2 Diabetes in Impaired Glucose Tolerance: The Finnish Diabetes Prevention Study

• Published in: Diabetes care Vol. 32; no. 11; pp. 1965 - 1971
• Main Authors: Tuomilehto, Henri, Peltonen, Markku, Partinen, Markku, Lavigne, Gilles, Eriksson, Johan G, Herder, Christian, Aunola, Sirkka, Keinänen-Kiukaanniemi, Sirkka, Ilanne-Parikka, Pirjo, Uusitupa, Matti, Tuomilehto, Jaakko, Lindström, Jaana
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01-11-2009
• Subjects: Analysis; Behavior modification; Biological and medical sciences; Blood Pressure; C-Reactive Protein - metabolism; Dextrose; Diabetes; Diabetes Mellitus, Type 2 - epidemiology; Diabetes therapy; Diabetes. Impaired glucose tolerance; Dietary Fats; Dietary Fiber; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Energy Intake; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Finland - epidemiology; Follow-Up Studies; Glucose; Glucose Intolerance - complications; Glucose Intolerance - epidemiology; Humans; Incidence; Life Style; Male; Medical research; Medical sciences; Metabolic diseases; Metabolic syndrome; Middle Aged; Miscellaneous; Mortality; Motor Activity - physiology; Older people; Original Research; Physical fitness; Prevention; Public health. Hygiene; Public health. Hygiene-occupational medicine; Rest - physiology; Risk Factors; Sleep - physiology; Statistical methods; Studies; Type 2 diabetes; Waist Circumference; Europe; Finland; Endocrinopathy; Type 2 diabetes; Human; Nutrition; Metabolic diseases; Duration; Epidemiology; Incidence; Prevention; Sleep; Sleep wake cycle; Impaired glucose tolerance; Endocrinology; Life style
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/dc08-1980

OBJECTIVE: Both short and long sleep duration have frequently been found to be associated with an increased risk for diabetes. The aim of the present exploratory analysis was to examine the association between sleep duration and type 2 diabetes after lifestyle intervention in overweight individuals with impaired glucose tolerance in a 7-year prospective follow-up. RESEARCH DESIGN AND METHODS: A total of 522 individuals (aged 40-64 years) were randomly allocated either to an intensive diet-exercise counseling group or to a control group. Diabetes incidence during follow-up was calculated according to sleep duration at baseline. Sleep duration was obtained for a 24-h period. Physical activity, dietary intakes, body weight, and immune mediators (C-reactive protein and interleukin-6) were measured. RESULTS: Interaction between sleep duration and treatment group was statistically significant (P = 0.003). In the control group, the adjusted hazard ratios (HRs) (95% CI) for diabetes were 2.29 (1.38-3.80) and 2.74 (1.67-4.50) in the sleep duration groups 9-9.5 h and greater-than-or-equal10 h, respectively, compared with for that of the 7-8.5 h group. In contrast, sleep duration did not influence the incidence of diabetes in the intervention group; for sleep duration groups 9-9.5 h and greater-than-or-equal10 h, the adjusted HRs (95% CI) were 1.10 (0.60-2.01) and 0.73 (0.34-1.56), respectively, compared with that in the reference group (7-8.5 h sleep). Lifestyle intervention resulted in similar improvement in body weight, insulin sensitivity, and immune mediator levels regardless of sleep duration. CONCLUSIONS: Long sleep duration is associated with increased type 2 diabetes risk. Lifestyle intervention with the aim of weight reduction, healthy diet, and increased physical activity may ameliorate some of this excess risk.