Regardless of the type of diabetes, there is twice the risk of experiencing cardiovascular (CV) disease complications in comparison to not having the disease. Although these complications and associated symptoms are rarely noted in adolescents with diabetes, early identification of biobehavioral markers for CV risks are essential for targeted approaches for prevention of later disease sequelae. Decreased sleep quality and heart rate variability (HRV) have both independently been associated with diabetes or the presence of obesity and risk for developing diabetes, as well as with CV disease. Studies exploring both sleep quality and HRV in adolescents with diabetes are not available. Thus, we conducted a secondary analysis of data from an existing study to examine differences in sleep quality and HRV in adolescents with type 1 (T1D) vs. type 2 diabetes (T2D); and to determine if there were associations between HRV and sleep quality. Adolescents with T1D (n = 101; 56 males) or T2D (n= 37; 16 males) completed 24-hour HRV Holter monitoring and measurement using Burdick Vision Premier™ ECG Analysis and Editing software system (Waukesha, WI), hemoglobin A1c (HbA1c) using the Abbott IMx® assay method, and a self-report global measure of the impact of diabetes on their sleep quality using a 5-point Likert scale. Duration of diabetes was greater (P \ .001) and measures of HRV were higher in T1D (P \ .01); BMI and BMI z-scores (P \ .001) and systolic and diastolic BP (P ≤ .05) were higher in T2D. No differences in recent or average HbA1c, Tanner staging or sleep quality were found. Both spectral and time domain measures of HRV were associated with sleep quality in T2D (r = - .51 to -.38, P \ .02); only time domain measures were associated with sleep quality in T1D (r = -. 21 to -.19, P ≤ .05). Poorer sleep quality was evident in those with lower HRV; these linkages were stronger in those with T2D. Further study is warranted to elucidate risks and improve sleep quality and CV outcomes in youth with diabetes.

Disclosure

M.S. Faulkner: None. A. Helvig: None.

© 2018 by the American Diabetes Association.
2018
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