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Sleep duration and risk of microvascular complications in type 2 diabetes: A prospective cohort study
Yanning Zhou1, Jialin Li2, Yonghai Wu3
1Department of Endocrinology and Metabolism, The First Affiliated Hospital of Ningbo University, Ningbo, China; Health Science Center, Ningbo University, Ningbo, China.
Background:
Longitudinal evidence on sleep duration's effects on type 2 diabetes mellitus (T2DM) microvascular outcomes, particularly in Asian populations, remains limited. This study investigated the prospective association between sleep duration and microvascular complication incidence in T2DM patients.
Methods:
This prospective cohort included 1236 T2DM adults, free of microvascular complications at baseline from National Metabolic Management Centre Ningbo Branch (2018-2023). Self-reported sleep duration was categorized into 5 groups (<7, 7-8, 8-9, 9-10, or ≥10h). Incident diabetic kidney disease (DKD), retinopathy (DR), and peripheral neuropathy (DPN) were ascertained. Cox regression and restricted cubic spline analyses estimated hazard ratio (HRs) and dose-response relationships.
Results:
In 2459 person-years, 237 participants developed microvascular complications. A U-shaped association emerged between sleep duration and composite microvascular complications (P < 0.001) and DPN (P = 0.039), with lowest risk at 7-8h. Compared to 7-8h, shorter (<7h) and longer (≥10h) durations significantly increased composite microvascular complication risks (HR = 1.71, P = 0.018; HR = 1.87, P = 0.005). No statistically significant interactions were observed between sleep duration and age, BMI, sedentary time, or sleep quality (all P for interaction >0.05).
Conclusion:
Both insufficient and excessive sleep increase T2DM microvascular complication risks. Maintaining 7-8 h of sleep daily may be a vital behavioral target in comprehensive T2DM management, potentially reducing microvascular complication burden.
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