Can Your Diabetes Be Keeping You Up At Night?

Stephanie Holt, PharmD Candidate 2011

Consumer Health Information Corporation and

University of Utah School of Pharmacy

An old saying states, “Early to bed, early to rise, makes a man healthy, wealthy, and wise.”  This may be true.  But unfortunately for millions of Americans, this is not an option.  Approximately 45% of Americans suffer from some form of sleep disturbances.  People are not well rested even with earlier bedtimes. 

This raises the question, “What is more important – the time you spend asleep or how well you sleep?”  Recent studies link diabetes to insomnia and vice versa.  Diabetes has always been a big health concern because of its long list of complications.  Now insomnia has been added to the list. 

What Came First: Diabetes or Insomnia?

It is important to understand that when you develop diabetes, your body no longer functions properly.  Diabetes is a disorder defined by high blood sugar.  The body tries to adjust to more available sugar, but over time, cannot keep up.  Slowly, the body gets tired and eventually begins to work at a slower pace.  Research shows sleep is closely related to how well the body works.  This explains why people with diabetes are at a higher risk of not sleeping well.  Similarly, people with sleep disturbances are also at a higher risk to develop diabetes.  Because diabetes and insomnia contribute to one another, it is important to take the correct steps to obtain a good night’s sleep and control diabetes.

Bridging the Link

New research suggests diabetes and sleep loss are also connected to your body’s circadian rhythm.  The circadian rhythm is your ‘body clock”.  It works 24 hours a day and helps your body regulate temperature, hunger, and your sleep cycle.  When these cycles work correctly, people sleep better and are healthier. 

The body clock is most affected by sleep patterns and meal times.  Late night eating, jet lag or night shifts can throw the clock out of rhythm.  When this occurs people are more likely to have less energy, bigger appetites, higher blood sugar levels and more sleep disruptions.  A late dinner or bedtime once in a while probably will not have a big impact.  Over time, these little changes can make you more likely to develop diabetes, insomnia and obesity.  Decide to choose a healthy, consistent diet and commit to a regular bedtime.  Your body will follow its natural rhythm and you will feel better.

Develop a Personal Plan 

Patients with insomnia and diabetes need to manage their care.  Although you cannot always control your diagnosis, you can help control the outcome.  Here are some suggestions to control diabetes and sleep better throughout the night. 

• Avoid large meals in the evening.  Studies show the body gets the most effect from sugar eaten in the morning and becomes less efficient as the day progresses.  If two people eat identical meals, one in the morning and one at night, the person at night has a harder time using up the sugar.  Eventually this leads to a higher risk of weight gain and diabetes.

• Limit saturated fat to less than 7 percent of your total calories.

• Minimize trans fats in your diet.  This will help lower your bad cholesterol and raise your good cholesterol.

• Limit your alcohol intake. Drink no more than 1 drink for women and 2 drinks for men per day.

• Evidence does not support the use of chromium and antioxidants to help control diabetes.  A benefit has not been shown for diabetic control from using these products.

• Exercise regularly.  Exercise improves sleep and helps control diabetes.  This happens even without weight loss.  Try to exercise at least 3 times a week for 50 minutes.  If you cannot do this, begin by starting simple and slowly build up.  With exercise, every little bit helps.

• Monitor carbohydrates.  You can use carb counting or exchanges to help achieve your blood sugar goals.

• Monitor your blood sugars at home.  Take your sugar levels as directed by your doctor and keep track of the values.  Notice the usual range of your values.  The goal is to have a pre-meal values lower than 130 mg/dL.      

• See your doctor regularly.  Patients with diabetes need to be seen every 3-6 months. 

• Take medications as directed by your doctor.  Besides diet and exercise, this is the only way to prevent complications.  If you take a lot of medications, purchase a pill box organizer from a pharmacy. 

• Refill your prescriptions.  Most insurance companies allow refills after 80% of your medication is gone.  Refill your medications early to prevent running out of medicine.  If this is a recurring problem, ask your pharmacy if they can enroll you in an automated refill service.  Also, many pharmacies offer online refill services.

• Have a set sleep schedule.  It takes a few days for the body to adapt to a new sleep schedule.  Consistent bedtimes ‘train’ the body for more complete sleep. 

• Avoid caffeine before bedtime.  This includes drinks such as coffee, tea, sodas and even chocolate.

• Reserve the bedroom for sleep and intimacy.  Try not to perform other tasks in your bedroom which can be performed elsewhere.  This includes studying, exercise, laundry and even television.

For these suggestions which are harder to implement, start by creating a 2-week goal for yourself.  Make the goal as simple as you need. Some examples of 2-week goals can be to walk around the neighborhood for 10 minutes; or, lift soup cans above your head for 5 minutes. 

© 2010 Consumer Health Information Corporation. All rights reserved.