Sleep, Glycemic Control, and Insulin Resistance in Adolescents With Type 1 Diabetes

University of Colorado, Denver23 enrolled

Overview

Despite advancements in care, most adolescents with T1D have higher BMI and significantly higher HbA1c than recommended and are markedly IR, placing them at increased risk for CVD1,2. Thus, alternative approaches to improve and maintain glycemic control, IR, and BMI for adolescents with T1D are urgently needed. This proposal moves beyond the current insulin and carbohydrate counting-focused lifestyle change paradigm to focus on sleep and circadian misalignment, which will allow for identification of new mechanisms that can be directly translated into future intervention and prevention trials. The goal of the current study is to utilize multiple objective measures of sleep duration, timing (actigraphy), and circadian rhythm (melatonin) in adolescents with type 1 diabetes (T1D; N = 40) and examine relationships with glycemic control, IR, vascular health, and BMI. Further, qualitative methodology will be used to identify barriers and facilitators to healthy sleep in adolescents with T1D.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Type1diabetes Adolescent Behavior Sleep

Interventions

Eligibility

Sex: ALLMin age: 14 YearsMax age: 19 Years

Medical Language ↔ Plain English

Inclusion Criteria: * attending high school * diagnosis of type 1 diabetes \>1 year Exclusion Criteria: * current diagnosis of a sleep disorder (e.g., insomnia, OSA) or abnormal scores on sleep disorders screening measures * regular use of medications affecting sleep (e.g., stimulants, atypical antipsychotics, melatonin, other sleep aids) * HbA1c ≥11 or \>14% for the previous 2+ measurements * IQ\<70 or severe mental illness

Outcomes

Primary Outcomes

HbA1c

Time frame: at 60 days

glycemic variability

CGM glucose SD

Time frame: at 2 weeks

insulin sensitivity from hyperinsulinemic euglycemic clamp

Time frame: at study entry (baseline)

BMI

body mass index