DOI: 10.4103/ijem.ijem_936_25 ISSN: 2230-8210

Sleep Quality and Glycaemic Control in Adults with Type 2 Diabetes: Associations with Metabolic Parameters, non-alcoholic fatty liver disease, and Appetite-Regulating Hormones

Sachin R.K. Krishna, Ashutosh K. Arya, Yashdeep Gupta, Devasenathipathy Kandasamy, Mani Kalaivani, Viveka P. Jyotsna, Nikhil Tandon
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Abstract

Introduction:

To determine prevalence of poor sleep quality using Pittsburgh University Sleep Quality Index (PSQI) and its association with glycaemic control, dyslipidaemia, non-alcoholic fatty liver disease (NAFLD), leptin, and ghrelin in type 2 diabetes (T2DM).

Methods:

This cross-sectional study enrolled 216 adults with T2DM from a tertiary care hospital in North India. Sleep quality was assessed using PSQI. Fasting blood samples were analysed for HbA1c, glucose, lipids, insulin, leptin, and acylated ghrelin. NAFLD was assessed by ultrasound. Correlation between sleep quality and different metabolic parameters was assessed.

Results:

Poor sleep quality (PSQI > 5) was present in 39.8% of participants. The global PSQI score correlated significantly with higher HbA1c (r = 0.173, P = 0.011) and fasting plasma glucose (FPG) (r = 0.223, P = 0.001). Among the PSQI components, sleep latency and sleep disturbances (components 4 and 5) had most significant associations with poorer glycaemic control ( P < 0.050). In regression models, a bidirectional relationship was observed: Higher fasting plasma glucose independently predicted worse PSQI scores (β = 0.27, P = 0.023), and worse PSQI scores independently predicted higher fasting plasma glucose (β = 4.20, P = 0.006). Poorer sleep also correlated with higher total and LDL cholesterol ( P < 0.050). No significant associations were found between sleep quality and NAFLD, serum leptin, or ghrelin.

Conclusion:

There was a high prevalence of poor sleep quality in Indian patients with T2DM. Regression analysis revealed a bidirectional link between poor sleep and poor glycaemic control. This suggests that poor sleep quality correlates with glycaemic and metabolic dysregulation, hence highlighting sleep as a critical, modifiable target for diabetes management.

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