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71 views2 pages

Trivedi2019 PDF

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Maria
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Published online: 28.06.

2019

THIEME
Letter to the Editor 39

The Role of Sleep Disruption and Negative Emotions


as Risk Factors in Diabetes Management
Gunjan Y. Trivedi1  Banshi Saboo2

1Society for Energy and Emotions, Wellness Space, Ahmedabad, Address for correspondence Gunjan Y. Trivedi, Wellness Space,
Gujarat, India 119C Swastik Society, Navrangpura, Ahmedabad 380 009, Gujarat,
2 Diacare, Ahmedabad, Gujarat, India. India (e-mail: [email protected]).

J Soc Health Diab 2019;7:39–40

Risk factors for type 2 diabetes (T2D) are well documented: problems that often coexist. The studies also have validat-
(1) physical inactivity, (2) family history, (3) unhealthy eating, ed the need for T2DM patients to be screened for sleep
and (4) overweight (obesity).1 For clinical management of disruption.6
T2D, the focus is on the modifiable factors to slow down the 4. Studies have also confirmed a reciprocal link between
disease progression and manage the risk of complications depression and obesity. Depression is an important risk
(e.g., cardiovascular disease [CVD] or renal complications or factor not only in binge eating but also in development
neuropathy). In a way, beyond family history, all the modi- of obesity. At the same time, obesity is found to increase
fiable factors are interrelated; that is, unhealthy eating and the depression risk.7 Further reviews also demonstrate a
physical inactivity lead to obesity, which further affects correlation between negative affect (mood) and increased
disease progression. In the context of energy expenditure, glucose level.8-10
this can be articulated as energy imbalance (between energy
The emerging evidence of the links between sleep
intake vs. energy expenditure) impacting the body weight
disruption, negative mood (or depression), and obesity provide
(obesity) that increases the risk of T2D or creates challenges
new possibilities for social research in the area of chronic
for management of existing T2D.
disease, especially T2D. For a healthy society and quality
Based on research over the past few years, there is an
T2D management, following two areas could be added into
opportunity to revisit the risk factors and its categories for
future studies:
T2D as the aforementioned factors are more physiological
and new factors related to sleep imbalance and emotional 1. Sleep-related and daytime energy recovery, overall energy
imbalance (negative emotions) have emerged. These new expenditure, and its correlation with obesity.
risk factors contribute to homeostatic imbalance of the 2. The role of emotional balance (specifically, reduction in
­energy, nervous system, endocrine system and ­circulatory negative affect) and its impact on obesity.
systems (including immune system). The findings below
make a possible case for addition of (1) sleep disruption and Conflict of Interest
(2) ­negative emotions (or depression) as additional risk fac- None declared.
tors for ­diabetes as well as its complications:

1. Poor-quality sleep affects the energy balance via modula- References


tion of neuroendocrine function and glucose metabolism. 1 International Diabetes Federation Accessed March 6, 2019
As a result, the body tends to increase the food intake and 2 Penev PD. Update on energy homeostasis and insufficient
conserve the energy. In short, poor-quality sleep predis- sleep. J Clin Endocrinol Metab 2012;97(6):1792–1801
3 Koren D, Dumin M, Gozal D. Role of sleep quality in the meta-
poses the risk of T2D.2,3
bolic syndrome. Diabetes Metab Syndr Obes 2016;9:281–310
2. Recent epidemiological and laboratory evidence confirms 4 Beccuti G, Pannain S. Sleep and obesity. Curr Opin Clin Nutr
the previous findings of an association between sleep loss Metab Care 2011;14(4):402–412
and increased risk of obesity. Studies have also demon- 5 Nedeltcheva AV, Scheer FA. Metabolic effects of sleep
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and increased incidence of chronic disease (incl. obesity, Diabetes Obes 2014;21(4):293–298
6 Khandelwal D, Dutta D, Chittawar S, Kalra S. Sleep disorders in
T2D, and CVD).4,5
type 2 diabetes. Indian J Endocrinol Metab 2017;21(5):758–761
3. While the causal role of sleep disruption in T2D is not yet 7 Luppino FS, de Wit LM, Bouvy PF, et al. Overweight, obesity,
documented, there is sufficient evidence that type 2 dia- and depression: a systematic review and meta-analysis of
betes mellitus (T2DM) and sleep disorders are common longitudinal studies. Arch Gen Psychiatry 2010;67(3):220–229

received DOI https://doi.org/ ©2019 Novo Nordisk Education


March 17, 2019 10.1055/s-0039-1692372 Foundation
accepted ISSN 2321-0656.
March 17, 2019
40 Letter to the Editor

8 Skaff MM, Mullan JT, Almeida DM, et al. Daily negative mood 10 Pan A, Keum N, Okereke OI, et al. Bidirectional association
affects fasting glucose in type 2 diabetes. Health Psychol between depression and metabolic syndrome: a systematic
2009;28(3):265–272 review and meta-analysis of epidemiological studies. Diabetes
9 Tabák AG, Akbaraly TN, Batty GD, Kivimäki M. Depression Care 2012;35(5):1171–1180
and type 2 diabetes: a causal association? Lancet Diabetes
Endocrinol 2014;2(3):236–245

Journal of Social Health and Diabetes  Vol. 7  No. 1/2019

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