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    Effects of sleep disorders and 25-OH Vitamin D levels on HbA1c levels in geriatric type 2 diabetic patients.
    (Allied Acad, 2016) Keskin, Ahmet; Bilge, Ugur; Unalacak, Murat; Kilic, Seda; Yildiz, Pinar; Selcuk, Engin Burak; Bilgin, Muzaffer
    Introduction: Sleep disorders and insufficient vitamin D levels can impair control of diabetes mellitus. The aim of this study was to determine the prevalence of sleep disorders by using Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI) and by comparing them with a control group, and to investigate the possible relationship among sleep disorders, scores, 25-OH Vitamin D levels (25VD) and HbA1C levels. Materials and method: This study was conducted in type 2 diabetic patients who attended to the family medicine outpatient clinic for routine controls. One hundred and six geriatric patients having type 2 diabetes were included in the study, and simultaneously selected 102 adult age group patients were taken as controls. Blood analyses for routine diabetes control parameters (HbA1c, fasting blood glucose, lipid profile) were performed. Target value for HbA1C was accepted as below %7. Demographic form, the Pittsburgh Sleep Quality Index, and Epworth Sleepiness Scale were used as the data collection instruments. Results: There are significant differences in PSQI and ESS scores between adult and geriatric diabetic patients (6.16 +/- 3.62 vs 6.96 +/- 3.42, p=0.070 and 7.84 +/- 5.37, p <0.001, respectively). 25VD levels were found as 22.40 +/- 13.85 ng/ml in the adult group, 18.65 +/- 14.17 ng/ml in the geriatric group. There is a significant difference between the groups in terms of vitamin D levels (p=0.007). Epworth categories were found to have an effect on HbA1c levels in geriatric patients. Changes in levels of ESS scores were found to be related with 4.784 fold increase in HbA1c levels. Vitamin D levels and ESS scores have major effects on HbA1C levels in elderly population (p=0.007, 0.001, respectively). Conclusion: In elderly patients, low 25VD levels and daytime sleepiness are associated with abnormal HbA1c levels. These results are important indicators of roles of sleep quality and VD deficiency in glycemic control for elderly patients. In elderly diabetic patients, with difficult blood glucose regulation, sleep problems and VD deficiency must be considered.
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    Effects of Sleep Disorders on Hemoglobin A1c Levels in Type 2 Diabetic Patients
    (Lippincott Williams & Wilkins, 2015) Keskin, Ahmet; Unalacak, Murat; Bilge, Ugur; Yildiz, Pinar; Guler, Seda; Selcuk, Engin Burak; Bilgin, Muzaffer
    Background: Studies have reported the presence of sleep disorders in approximately 50-70% of diabetic patients, and these may contribute to poor glycemic control, diabetic neuropathy, and overnight hypoglycemia. The aim of this study was to determine the frequency of sleep disorders in diabetic patients, and to investigate possible relationships between scores of these sleep disorders and obstructive sleep apnea syndrome (OSAS) and diabetic parameters (fasting blood glucose, glycated hemoglobin A1c [HbA1c], and lipid levels). Methods: We used the Berlin questionnaire (BQ) for OSAS, the Epworth Sleepiness Scale (ESS), and the Pittsburgh Sleep Quality Index (PSQI) to determine the frequency of sleep disorders and their possible relationships with fasting blood glucose, HbA1c, and lipid levels. Results: The study included 585 type 2 diabetic patients admitted to family medicine clinics between October and December 2014. Sleep, sleep quality, and sleep scores were used as the dependent variables in the analysis. The ESS scores showed that 54.40% of patients experienced excessive daytime sleepiness, and according to the PSQI, 64.30% experienced poor-quality sleep. The BQ results indicated that 50.20% of patients were at high-risk of OSAS. HbAlc levels correlated significantly with the ESS and PSQI results (r = 0.23, P < 0.001 and r = 0.14, P = 0.001, respectively), and were significantly higher in those with high-risk of OSAS as defined by the BQ (P < 0.001). These results showed that HbAlc levels were related to sleep disorders. Conclusions: Sleep disorders are common in diabetic patients and negatively affect the control of diabetes. Conversely, poor diabetes control is an important factor disturbing sleep quality. Addressing sleep disturbances in patients who have difficulty controlling their blood glucose has dual benefits: Preventing diabetic complications caused by sleep disturbance and improving diabetes control.