ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2019) 63 GP214 | DOI: 10.1530/endoabs.63.GP214

Association between sleep disturbances and fear of hypoglycemia in adults with type 1 diabetes, data from VARDIA Study

Valentine Suteau1,2, Pierre-Jean Saulnier3,4, Matthieu Wargny5, Elise Gand3, Lucy Chaillous5, Séverine Dubois2, Ingrid Allix2, Fabrice Bonnet6, Anne-Marie Leguerrier6, Gérard Fradet7, Isabelle Delcourt Crespin7, Véronique Kerlan8, Didier Gouet9, Caroline Perlemoine10, Pierre-Henri Ducluzeau11, Matthieu Pichelin5, Linda Gonder-Frederic12, Stéphanie Ragot4, Samy Hadjhadj5, Bertrand Cariou5 & Claire Briet1,2

1Institut MITOVASC, UMR CNRS 6015, INSERM 1083, Université d’Angers, Angers, France; 2Diabetes Department, CHU d’Angers, Angers, France; 3University of Poitiers, INSERM Clinical Investigation Center CIC1402, Poitiers, France; 4CHU Poitiers, Diabetes Department, Poitiers, France; 5L’institut du thorax, CHU Nantes, INSERM CIC1413, Nantes, France; 6CHU Rennes, Diabetes Department, Rennes, France; 7CH La Roche sur Yon, La Roche sur Yon, France; 8CHU Brest, Diabetes Department, Brest, France; 9CH La Rochelle, Diabetes Department, La Rochelle, France; 10CH Lorient, Diabetes Departme, Lorient, France; 11Diabetes Department, Tours, France; 12University of Virginia, Charlotteville, USA.

Aims: To assess the relationship between sleep quality and fear of hypoglycemia, glycemic variability and other diabetes-related outcomes in type 1 diabetes.

Methods: Our data were provided by the VARDIA Study, a multicentric observational cross-sectional study conducted between June and December 2015. Sleep characteristics were assessed by Pittsburgh Sleep Quality Index (PQ1I). Fear of hypoglycemia was measured with the Hypoglycemia Fear Survey version II (HFS-II). Glycemic variability was determined using the CV of three 7-points self-monitoring blood glucose profiles and the mean amplitude of glycemic excursion (MAGE). Comparisons between ‘good’ (PQ1I≤5) and ‘poor’ (PQ1I>5) sleepers and correlation between PQ1I and these different parameters were tested.

Results: 315 patients were eligible for PQ1I questionnaire analysis: 54% women, mean age 47±15 years old, mean diabetes duration of 24±13 years, HbA1c of 7.6±0.9% (60±7.5 mmol/mol). Average PQ1I score was 6.0±3.3 and 59.8% of the patients had a total PQ1I score >5. HFS-II score was significantly higher among patients with sleep disturbances (P<0.0001) and global PQ1I score was positively correlated with HFS-II (β=0.19; 95% CI=0.07;0.30). GV evaluated by CV or MAGE did not differ between ‘poor’ and ‘good’ sleepers (P=0.28 and 0.54, respectively).

Conclusions: Adult patients with type 1 diabetes have disturbed sleep quality which correlate with fear of hypoglycemia. This study suggests that fear of hypoglycemia is a target for intervention to improve sleep quality in adults with type 1 diabetes.

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