Background: 77% of people with diabetes have some form of insomnia. Sleep disturbance results in impaired glucose control in healthy individuals or worsens glucose control in people with diabetes. Short-term sleep studies (1-6 weeks) improved glucose control and insulin resistance in obese “healthy” individuals. We have shown before the superior benefit Trazodone has in treating neuropathy over gabapentin. We show, in this abstract, the impact of improving sleep may have on glucose control.

Methods: we treated 200 type 2 patients with diabetic neuropathy with either trazodone (100), or Gabapentin(100), compared the change in neuropathy, sleep and glucose control. We quantified their neuropathy with our previously published neuropathy grading system (Sakkal’s Scale: level of vibration sensory loss by the 128 tuning fork) we quantified their sleep with shortening latency of sleep onset, and sleep duration extension. We measured their glucose control with AM insulin-to-glucose ratio, HgA1c, and in-target glucose when CGMS was available (20 patients). We excluded patients with OSA. All patients followed our standard diabetes treatment protocol for type 2.

Results: At 12 months, Trazodone improved the scale of diabetic neuropathy in 80% of patients, sleep hygiene in 70%; Sleep increased by 40 minutes, and sleep onset latency decreased by 10 minutes. Insulin/glucose ratio was 21/142=0.147, HgA1c 7.2%, HgA1c<7 in 68%, and in-target glucose in 72% on CGMS(12 patients). Gabapentin improved the scale of diabetic neuropathy in 66%, sleep hygiene in 44%; with sleep increasing by 14 minutes, and sleep onset latency decreased by 4 minutes. Insulin -to-Glucose ratio was 33/166=0.19, HgA1c 7.8%,HgA1c,7 in 56%, and in-target-glucose in 58% on CGMS (8 patients.) analysis. A maximum number of diabetes medications used were 3 in both groups. Percentage needing basal insulin at the end was 12% in the Trazodone group, 21% in the Gabapentin group.

Conclusion: Improved sleep and neuropathy with Trazodone improved glucose control.

Disclosure

S. Sakkal: None.

© 2018 by the American Diabetes Association.
2018
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