Diabetic coma and sleep management -
Few studies have been developed to determine the underlying mechanisms for the observed associations between sleep and glycemic control.
Insulin sensitivity was decreased after a single night of partial sleep restriction compared to a normal night of sleep 4 vs. This finding suggests that sleep restriction, a common behavior in the population, may negatively influence glycemic control.
However, more interventional studies are needed to fully determine the mechanisms underlying reported associations between sleep disturbance and glucose regulation. Such research will help to inform clinical management strategies for type 1 diabetes.
Sleep-disordered breathing is one of the most prevalent sleep disorders. Obstructive sleep apnea OSA and type 2 diabetes frequently occur together, and there is strong evidence to suggest the two pathologies are linked. Few studies have investigated the prevalence of sleep apnea in type 1 diabetes.
In another study of adults with diabetes 58 with type 1 diabetes , However, only 1. Subjects who had OSA were older, had a longer duration of diabetes, and were more likely to have retinopathy than those who did not have OSA OSA was common in a group of normal-weight mean BMI Although limited, these studies demonstrate that OSA is more common among individuals with type 1 diabetes than among those without diabetes, and the presence and severity of OSA are linked to glycemic control in both children and adults with type 1 diabetes.
Larger-scale studies are needed to confirm these findings. Studies investigating the incidence of other sleep disorders such as insomnia and narcolepsy in type 1 diabetes have not been reported in the literature. One study found that restless legs syndrome, a problem that is common in adulthood but of unknown prevalence in childhood, was not more common among children with type 1 diabetes than among healthy control subjects 5.
Research has shown that individuals with type 1 diabetes have a decreased awakening response to hypoglycemia during sleep 16 , 17 , which could be the result of decreased counterregulatory response 18 — Unfortunately, nocturnal hypoglycemia is a common occurrence in both children and adults with type 1 diabetes 21 — Adults subjectively report that nonsevere hypoglycemic events disrupt their sleep, and many have difficulty falling back to sleep after treating their hypoglycemia 25 , The impact of hypoglycemia on sleep architecture has been minimally investigated.
However, only 6 of the total 20 subjects experienced hypoglycemia in this study, in which blood glucose was obtained via intravenous catheter every 30 minutes In another study, the number of full awakenings was significantly higher in children with type 1 diabetes, but there was no relationship between awakenings and the occurrence of hypoglycemia measured by continuous glucose monitoring In the same study, slow-wave sleep stages 3 and 4 was significantly more prevalent during episodes of hypoglycemia.
Using actigraphy to discriminate between sleep and wakefulness, hypoglycemia during sleep was associated with increased motor activity in adolescents with type 1 diabetes Few studies have addressed the impact of hypoglycemia on sleep architecture in adults with type 1 diabetes.
Still, the prevalence of nocturnal hypoglycemia combined with anecdotal subjective reports of sleep disruption from hypoglycemia highlight the need for future studies designed to fully characterize the impact of hypoglycemia-related sleep disruption. Interestingly, it has been reported that hypoglycemia does not alter the acoustic arousal threshold in adolescents with type 1 diabetes 17 , indicating that alarms may be helpful in alerting individuals when hypoglycemia occurs during sleep.
Melatonin is an important regulator of the sleep-wake cycle. These results suggest that hyperglycemia may negatively affect maintenance of a normal circadian cycle.
Minimal research has been done investigating the direct impacts of hyperglycemia on sleep. As reviewed previously, there is a strong connection between disrupted sleep and poorer glycemic control; however, these studies were unable to determine causality.
As noted above, one study found that sleep restriction led to impaired insulin sensitivity the next day in individuals with type 1 diabetes, which would disrupt glycemic control It also is possible that sleep may be disrupted by the symptoms of hyperglycemia.
Hyperglycemia leads to osmotic diuresis, resulting in the need to urinate more frequently, which may lead to sleep disruption, although no studies investigating this phenomenon have been reported.
Studies comparing the effects of hyperglycemia versus euglycemia on sleep architecture in both children and adults are needed to determine whether hyperglycemia has a detrimental effect on sleep architecture.
Increased glycemic variability has been positively correlated with subjectively reported mean sleep latency 7. Pillar et al. This finding raises the possibility that the rate of change in glucose levels may affect sleep architecture.
These results highlight a need for more studies to investigate the influence of glucose variability, a common feature of type 1 diabetes, on sleep. Blood pressure normally declines during sleep; loss of this decline is associated with increased risk for sustained hypertension, as well as an accelerated rate of development of complications Larger studies that include a control group are needed to confirm whether short sleep duration increases the risk of or accelerates the development of cardiovascular and microvascular complications and whether this is specific to type 1 diabetes.
Evidence from the literature supports the likelihood that adults and children with type 1 diabetes have altered sleep architecture and reduced sleep quality relative to individuals without diabetes. Alterations in sleep architecture may be the result of both behavioral and physiological aspects of diabetes and its management.
Sleep apnea may be more prevalent in people with type 1 diabetes, and presence of OSA has been linked to impaired glycemic control. Furthermore, lack of the normal decline in blood pressure during sleep may be linked to short sleep duration in people with type 1 diabetes, and this may accelerate the development of cardiovascular and microvascular disease.
Additional research is needed to better understand the mechanisms determining why and how sleep is disrupted in individuals with type 1 diabetes and what impact sleep disruption may have on diabetes management and control. Sign In or Create an Account.
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Sleep Quality and Sleep Architecture Structure of Sleep. Effects of Disrupted Sleep on Glucose Control. Sleep Disorders. Impact of Diabetes Pathophysiology and Treatment on Sleep. Duality of Interest. Article Navigation. From Research to Practice February 01 Type 1 Diabetes and Sleep Sarah S. Farabi Sarah S.
Center for Narcolepsy, Sleep and Health Research, University of Illinois, Chicago, IL. Corresponding author: Sarah S.
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No potential conflicts of interest relevant to this article were reported. Those at most risk of this type of coma are people with type 2 diabetes, who have an infection or acute illness and have reduced their intake of fluids. The kidneys respond to high levels of blood glucose by doing their best to remove it, along with a great deal of water.
They will become dehydrated and urgently need intravenous fluids. Without this kind of treatment, they may lapse into hyperosmolar coma. Hyperosmolar coma develops slowly over several days or weeks, so if the high blood glucose levels or dehydration are detected and treated early, coma can be prevented.
Hypoglycaemia , or low blood glucose levels below 3. If the blood glucose falls to very low levels, the person may become unconscious hypoglycaemic coma and seizures may occur. First aid for someone who has lapsed into a diabetic coma includes:.
A coma is a medical emergency. The cause of a diabetic coma is diagnosed using a number of tests including:. This page has been produced in consultation with and approved by:.
Content on this website is provided for information purposes only. Information about a therapy, service, product or treatment does not in any way endorse or support such therapy, service, product or treatment and is not intended to replace advice from your doctor or other registered health professional.
The information and materials contained on this website are not intended to constitute a comprehensive guide concerning all aspects of the therapy, product or treatment described on the website.
All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions and to ascertain whether the particular therapy, service, product or treatment described on the website is suitable in their circumstances.
The State of Victoria and the Department of Health shall not bear any liability for reliance by any user on the materials contained on this website. Skip to main content. Home Diabetes. Diabetic coma. Actions for this page Listen Print. Summary Read the full fact sheet. On this page.
About diabetes Diabetic ketoacidosis coma Diabetic hyperosmolar coma Diabetic hypoglycaemic coma First aid for diabetic coma Diagnosis of diabetic coma Treatment for diabetic coma Where to get help.
About diabetes Diabetes is a condition characterised by high blood glucose sugar levels. Uncontrolled diabetes may lead to a diabetic coma or unconsciousness. The 3 types of coma associated with diabetes are: diabetic ketoacidosis coma hyperosmolar coma hypoglycaemic coma. Diabetic ketoacidosis coma Diabetic ketoacidosis typically occurs in people with type 1 diabetes, which was previously known as juvenile diabetes or insulin dependent diabetes mellitus IDDM , though it can occasionally occur in type 2 diabetes.
Symptoms of ketoacidosis Symptoms of ketoacidosis are: extreme thirst lethargy frequent urination due to high blood glucose levels nausea vomiting abdominal pain progressive drowsiness deep, rapid breathing a fruity or acetone smell on the breath. Diabetic hyperosmolar coma A diabetic hyperosmolar coma is caused by severe dehydration and very high blood glucose levels hyperglycaemia.
Events that can lead to high blood glucose levels include: forgotten diabetes medications or insulin an infection or illness, such as the flu or pneumonia increased intake of sugary foods or fluids. Diabetic hypoglycaemic coma Hypoglycaemia , or low blood glucose levels below 3.
Symptoms of hypoglycaemia Symptoms of hypoglycaemia include: tremor racing pulse or heart palpitations sweating weakness intense hunger confusion, altered behaviour, drowsiness or coma — these may occur if the blood glucose level becomes very low.
Prolonged or frequent coma should be avoided and hypoglycaemia needs to be treated quickly.
Diabetes Diabetic coma and sleep management a condition characterised by high blood glucose Aromatherapy for promoting emotional well-being levels. Diabetic ocma typically occurs in people with type 1 diabetes, which was previously known as juvenile diabetes or Diabetic coma and sleep management dependent diabetes sldep IDDMDiqbetic it can occasionally occur in type 2 diabetes. This type of coma is triggered by the build-up of chemicals called ketones. Ketones are strongly acidic and cause the blood to become too acidic. When there is not enough insulin circulating, the body cannot use glucose for energy. Instead, fat is broken down and then converted to ketones in the liver. The ketones can build up excessively when insulin levels remain too low.Diabetic coma and sleep management -
This type of coma is triggered by the build-up of chemicals called ketones. Ketones are strongly acidic and cause the blood to become too acidic. When there is not enough insulin circulating, the body cannot use glucose for energy.
Instead, fat is broken down and then converted to ketones in the liver. The ketones can build up excessively when insulin levels remain too low.
Common causes of ketoacidosis include a missed dose of insulin or an acute infection in a person with type 1 diabetes. Ketoacidosis may be the first sign that a person has developed type 1 diabetes.
In order to pick up the earliest signs of ketoacidosis, people with type 1 diabetes whose blood glucose levels are particularly high require more frequent monitoring of blood glucose.
Checking of ketone levels is also recommended. If available, blood ketone testing is preferred. If blood ketone testing is not available, urine testing may be used.
A diabetic hyperosmolar coma is caused by severe dehydration and very high blood glucose levels hyperglycaemia. Those at most risk of this type of coma are people with type 2 diabetes, who have an infection or acute illness and have reduced their intake of fluids.
The kidneys respond to high levels of blood glucose by doing their best to remove it, along with a great deal of water.
They will become dehydrated and urgently need intravenous fluids. Without this kind of treatment, they may lapse into hyperosmolar coma.
Hyperosmolar coma develops slowly over several days or weeks, so if the high blood glucose levels or dehydration are detected and treated early, coma can be prevented. Hypoglycaemia , or low blood glucose levels below 3. If the blood glucose falls to very low levels, the person may become unconscious hypoglycaemic coma and seizures may occur.
First aid for someone who has lapsed into a diabetic coma includes:. A coma is a medical emergency. The cause of a diabetic coma is diagnosed using a number of tests including:.
This page has been produced in consultation with and approved by:. Content on this website is provided for information purposes only. Information about a therapy, service, product or treatment does not in any way endorse or support such therapy, service, product or treatment and is not intended to replace advice from your doctor or other registered health professional.
The information and materials contained on this website are not intended to constitute a comprehensive guide concerning all aspects of the therapy, product or treatment described on the website. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions and to ascertain whether the particular therapy, service, product or treatment described on the website is suitable in their circumstances.
The State of Victoria and the Department of Health shall not bear any liability for reliance by any user on the materials contained on this website. Skip to main content. Home Diabetes. Diabetic coma. Actions for this page Listen Print. Summary Read the full fact sheet. Too little sleep can:. Sleep quality is as important as how many hours you get.
One of the best things you can do is to wake up and go to bed at around the same time every day, even on weekends, making sure you get enough quality sleep consistently. These tips can help:. Skip directly to site content Skip directly to page options Skip directly to A-Z link. Español Other Languages.
Sleep for a Good Cause. Español Spanish. Minus Related Pages. Getting good sleep is important for your mind, your body, and your diabetes. Get Good Sleep. Repeatedly waking up during the night. Having symptoms of sleep disorders such as snoring or gasping for air.
More Information. Learn More About Sleep Living With Diabetes CDC Diabetes on Facebook CDCDiabetes on Twitter. Page last reviewed: July 28, Content source: Centers for Disease Control and Prevention. home Diabetes Home. To receive updates about diabetes topics, enter your email address: Email Address.
Sarah Diabbetic. Farabi; Type 1 Diabetes Antibacterial HVAC filters Sleep. Diabetes Spectr 1 February Improving bowel health naturally 29 1 : 10— IN BRIEF In Diahetic with type 1 diabetes, sleep Slleep be disrupted as a result of both behavioral and physiological aspects of diabetes and its management. This sleep disruption may negatively affect disease progression and development of complications. This review highlights key research findings regarding sleep in people with type 1 diabetes. Recent research has increasingly identified sleep as a key process for the maintenance of good cardiovascular and metabolic health. 
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