Why Is Sleep Important for Patients With Diabetes?

[Northerner]

Diane is one of those patients who avoids taking medication at all costs. When I shared that her blood test results indicated prediabetes and suggested that she go on metformin, she hesitated, asking, "Oh no, isn't there something natural I can do?"

I responded, "How are you sleeping?"

"Not long and not great," she replied. "I'm usually tired in the morning."

"Then, let's try to improve your sleep first," I told her and explained that inadequate sleep impairs the body's ability to process sugar. "When you don't get quality sleep, the stress hormone cortisol increases, which releases stored glucose, making it harder for insulin to properly regulate sugar," I said.

Diane added that she tends to snack into the late evening, usually on cookies or tortilla chips, another habit that interferes with her sleep and her metabolism.

A prediabetes or diabetes diagnosis is often frightening to patients. But we physicians can ease their minds by giving them tools to manage their condition. And one of the best and most effective for them to manage is sleep.

Why Is Sleep Important for Patients With Diabetes?

Educating patients with diabetes about the importance of sleep can help ease patients' anxiety so they can get a good night's rest, says Florence Comite, MD.

www.medscape.com

Example is of Type 2, but of course good sleep is important for everyone 🙂

 

[Amity Island]

I'd also add that, without regular, regular sleep, this can dramatically affect insulin ratios for meals. I know from experience that my ratios start from time of waking. Starting at 3:10, 2:10 then 1:10 by the afternoon. Missing a nights sleep will effectively mean a continuation of the prior evenings ratio of 1:10 not the usual 3:10 when I wake from a full nights sleep.

 

[rebrascora]

I'd also add that, without regular, regular sleep, this can dramatically affect insulin ratios for meals. I know from experience that my ratios start from time of waking. Starting at 3:1, 2:1 then 1:1 by the afternoon. Missing a nights sleep will effectively mean a continuation of the prior evenings ratio of 1:1 not the usual 3:1 when I wake from a full nights sleep.

Are you suggesting that your insulin sensitivity improves when you miss a nights sleep or am I misreading your ratios or perhaps your post in general? I would expect the body to be more stressed if you didn't sleep and therefore more glucose would be released by the liver, unless you ate and were active through the night in which case the body may well need less insulin in the morning because it is at an end of an activity period, effectively negating DP/FOTF.
I assume you are talking carb portions rather than units to grams, but I think generally it is quoted as insulin:carbs these days with the insulin first, so I generally use a 1:10 ratio throughout the day (when I can be bothered to count carbs 🙄 ), but I add an extra 1.5-2 units to my morning dose to cover FOTF, but I need those regardless of whether I am having breakfast or not so I don't consider them part of my ratio.
I am guessing you don't mean 3 units of insulin to 1g carbs with a 3:1 ratio. Just having difficulty understanding the point you are making, so maybe I am wrong in that assumption or my understanding of your post in general.

 

[RichardsUsername]

I haven't had a good nights sleep in about 35 years. No joke and another thing I need to look at. I'm lucky if I get an hour in one go. Deep sleep which is the most important, I get none.

 

[harbottle]

Yes.

My problems started when I was so stressed with work and other things in early 2021 that I couldn't sleep. A few months of this and I started to get leg pains and blurred vision. Then came the diagnosis about six months later.

I found out afterwards that work colleagues were getting worried because I was in the office looking like a ghost...

 

[nonethewiser]

Always liked my sleep even before diagnosis of type 1 so sleep never come into play there.

Only time I've had limited sleep was when kids were little & was working permanent nights, wife also worked so sleep was split in two & often only got 4 hours sleep a day except when wife was off..

Now can be in bed by 9 & sleep till 6-7 in morning, sleep is so important for all round health so feel sorry for those who struggle with it.

 

[Amity Island]

Are you suggesting that your insulin sensitivity improves when you miss a nights sleep or am I misreading your ratios or perhaps your post in general? I would expect the body to be more stressed if you didn't sleep and therefore more glucose would be released by the liver, unless you ate and were active through the night in which case the body may well need less insulin in the morning because it is at an end of an activity period, effectively negating DP/FOTF.
I assume you are talking carb portions rather than units to grams, but I think generally it is quoted as insulin:carbs these days with the insulin first, so I generally use a 1:10 ratio throughout the day (when I can be bothered to count carbs 🙄 ), but I add an extra 1.5-2 units to my morning dose to cover FOTF, but I need those regardless of whether I am having breakfast or not so I don't consider them part of my ratio.
I am guessing you don't mean 3 units of insulin to 1g carbs with a 3:1 ratio. Just having difficulty understanding the point you are making, so maybe I am wrong in that assumption or my understanding of your post in general.

Sorry @rebrascora I was having a conversation with myself for a moment. I've corrected the ratios to 1 insulin unit : 10g carb ratio. In my head I see 10g as 1 carb unit hence 1:1 instead of 1:10g.

Regarding the changing ratios, if I miss a nights sleep, I no longer get the same insulin resistance upon waking thus no need for more insulin in the morning. The 1:10 ratio stays.

 

[Amity Island]

I haven't had a good nights sleep in about 35 years. No joke and another thing I need to look at. I'm lucky if I get an hour in one go. Deep sleep which is the most important, I get none.

Just out of interest, do you take vit d3 daily? And have you ever tried removing all msg from your diet? Msg aka as monosodium glutamate or E621. Things like some flavourings in crisps, gravy, some sausages, chinese foods, ready made foods.

 

[RichardsUsername]

Just out of interest, do you take vit d3 daily? And have you ever tried removing all msg from your diet? Msg aka as monosodium glutamate or E621. Things like some flavourings in crisps, gravy, some sausages, chinese foods, ready made foods.

No I don't. I did however watch a couple of videos on youtube the other day about passive suicide ideation and emotional neglect that rang a few bells.

 

[everydayupsanddowns]

No I don't. I did however watch a couple of videos on youtube the other day about passive suicide ideation and emotional neglect that rang a few bells.

Sorry to hear you find it so difficult to get quality sleep @RichardsUsername

Has this been the case for you for a while? Do you think some of the things you connected with in the videos may be impacting your ability to sleep and relax? Did you find the videos helpful or did they stir up some of your feelings in a way you found difficult (I think I remember you posting about some MH challenges you have worked through in the past?).

Let us know if there’s anything we can do or if it would be helpful to talk things through with someone?

 

[RichardsUsername]

Sorry to hear you find it so difficult to get quality sleep @RichardsUsername

Has this been the case for you for a while? Do you think some of the things you connected with in the videos may be impacting your ability to sleep and relax? Did you find the videos helpful or did they stir up some of your feelings in a way you found difficult (I think I remember you posting about some MH challenges you have worked through in the past?).

Let us know if there’s anything we can do or if it would be helpful to talk things through with someone?

Thank you. Yes the videos were helpful in as much as they confirmed emotional neglect has been a large part of my life and I wasn't aware S.I. Suicidal Ideation was a thing. It's a two edged sword though as talking about my mental health issues can just make things worse. However, I haven't met a lot of people that agree seeking help just makes things worse. And some will even make a point to try to prove me wrong. I get that no-one wants to admit that though. Bit of a no win situation I'm afraid. But I'm still here. Thanks again.

 

[everydayupsanddowns]

Thank you. Yes the videos were helpful in as much as they confirmed emotional neglect has been a large part of my life and I wasn't aware S.I. Suicidal Ideation was a thing. It's a two edged sword though as talking about my mental health issues can just make things worse. However, I haven't met a lot of people that agree seeking help just makes things worse. And some will even make a point to try to prove me wrong. I get that no-one wants to admit that though. Bit of a no win situation I'm afraid. But I'm still here. Thanks again.

Thanks for being so honest and candid @RichardsUsername

I’m sure that will help others, even if they are only lurking / reading anonymously.

I’ve always been rather cautious of the suggestion that talking about a person’s suicidal thinking is without downside. Not that I think it’s helpful for anyone to hide these thoughts, or that those questions are unaskable - but I think great care needs to be taken, and it’s not something to enter into casually, and especially not with another agenda!

 

[rebrascora]

Thank you. Yes the videos were helpful in as much as they confirmed emotional neglect has been a large part of my life and I wasn't aware S.I. Suicidal Ideation was a thing. It's a two edged sword though as talking about my mental health issues can just make things worse. However, I haven't met a lot of people that agree seeking help just makes things worse. And some will even make a point to try to prove me wrong. I get that no-one wants to admit that though. Bit of a no win situation I'm afraid. But I'm still here. Thanks again.

Yes, I don't find it helpful to talk about it either. I prefer distraction and being given time to come back up. I find withdrawing from people helps me because I have a tendency to take on other people's concerns and often compare myself to them and feel a fraud that I feel so low when I don't have the worries that other people do, so it just gives me another stick to beat myself with, whereas if I can just withdraw and have time, I know from experience that I come back up quicker.

 

[RichardsUsername]

Yes, I don't find it helpful to talk about it either. I prefer distraction and being given time to come back up. I find withdrawing from people helps me because I have a tendency to take on other people's concerns and often compare myself to them and feel a fraud that I feel so low when I don't have the worries that other people do, so it just gives me another stick to beat myself with, whereas if I can just withdraw and have time, I know from experience that I come back up quicker.

@rebrascora My favourite line is things could be a lot worse. I don't have to explain it all again then. And sleep for those that are interested is one of three ways people deal with suicidal thoughts, according to a guy on a Ted Talk that was responsible for the Golden Gate Bridge and people jumping off. The other two are drink or drugs and death. Goodnight.

 

[rebrascora]

@rebrascora My favourite line is things could be a lot worse. I don't have to explain it all again then. And sleep for those that are interested is one of three ways people deal with suicidal thoughts, according to a guy on a Ted Talk that was responsible for the Golden Gate Bridge and people jumping off. The other two are drink or drugs and death. Goodnight.

That is interesting. I guess I am lucky in this too as sleep is my refuge and usually I can sleep any time of day or night. Not saying I haven't used alcohol (thankfully not to excess except on very rare occasions) and I've definitely used food particularly sugar, to excess, but no other drugs.
I no longer have suicidal thoughts as such because I have learned from experience that I can weather the lows and I will come back up, usually in a few days.

 

[everydayupsanddowns]

But I'm still here

Well I’m very glad you are!

Hope you manage to find ways to improve your sleep, and that helps you further.

 

[RichardsUsername]

Well I’m very glad you are!

Hope you manage to find ways to improve your sleep, and that helps you further.

@everydayupsanddowns Thanks. I've looked into and implemented a whole raft of ways to improve my sleep. Starting years ago. So again. I know could do a lot better. Just need the motivation. Same as I do to get the diabetes and health as a whole in check.

@rebrascora I also feel I am lucky. Which given the mental and physical torture I have been getting recently is a bit weird. To be honest. But again, I am totally aware it could be a lot worse. Got a good perspective at the end of the day.