Role of sleep and circadian rhythm in treatment efficacy of antidiabetics

Sleep and circadian rhythm plays a significant role in glycemic control. Short/long sleep duration, together with sleep disorders such as insomnia and obstructive sleep apnoea are more prevalent in patients with type 2 diabetes than in the general population. In addition, mounting evidence suggests an association between circadian manifestations (chronotype) and risk of type 2 diabetes. Both sleep disruptions and circadian traits have been linked to cardiometabolic alterations that can exacerbate the pathophysiology of type 2 diabetes (e.g. hypertension). On the other hand, an important question remain uninvestigated is that whether sleep and circadian factors could modulate treatment efficacy of the commonly used antidiabetic therapies, such as metformin, gliclazide, and insulin among type 2 diabetes patients. Therefore, this study aims to test the moderating effect of sleep and circadian factors on glycemic control of the type 2 diabetes patients under antidiabetic treatment.
Three questions will be answered by utilizing UK Biobank baseline information within the upcoming 24 months:
1. Whether self-reported or actigraphy-determined sleep duration moderates the treatment efficacy of mainline antidiabetic therapies (e.g. metformin, gliclazide, and insulin).
2. Whether frequent insomnia complaints or potential sleep apnea moderates the treatment efficacy of mainline antidiabetic therapies.
3. Whether circadian rhythm based on self-reported chornotype or actigraphic data moderates the treatment efficacy of mainline antidiabetic therapies.
Findings of this research may provide new evidence, which shed light on the possible interventions for improving treatment efficacy of antidiabetics among type 2 diabetes patients.