Associations between glycemic variability, sleep quality, and daily steps in subjects without diabetes using wearable devices

Jun Inaishi; Kazuhiro Kashiwagi; Shotaro Kinoshita; Yasuyo Wada; Sayaka Hanashiro; Kiko Shiga; Momoko Kitazawa; Shiori Tsutsumi; Hiroyuki Yamakawa; Taishiro Kishimoto

doi:10.1016/j.metop.2023.100263

Associations between glycemic variability, sleep quality, and daily steps in subjects without diabetes using wearable devices

Metabol Open. 2023 Nov 17:20:100263. doi: 10.1016/j.metop.2023.100263. eCollection 2023 Dec.

Authors

Jun Inaishi^{1

2}, Kazuhiro Kashiwagi^{1

3}, Shotaro Kinoshita^{3

4}, Yasuyo Wada^{1

5}, Sayaka Hanashiro⁶, Kiko Shiga^{6

7}, Momoko Kitazawa⁶, Shiori Tsutsumi⁸, Hiroyuki Yamakawa¹, Taishiro Kishimoto^{3

9

10}

Affiliations

¹ Center for Preventive Medicine, Keio University Hospital, Tokyo, Japan.
² Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
³ Hills Joint Research Laboratory for Future Preventive Medicine and Wellness, School of Medicine, Keio University, Tokyo, Japan.
⁴ Graduate School of Interdisciplinary Information Studies, The University of Tokyo, Tokyo, Japan.
⁵ Department of Health Promotion, National Institute of Public Health, Saitama, Japan.
⁶ Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.
⁷ Department of Clinical Psychology, Faculty of Human Relations, Shigakukan University, Kagoshima, Japan.
⁸ Graduate School of Health Management, Keio University, Kanagawa, Japan.
⁹ Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, New York, USA.
¹⁰ Department of Psychiatry and Department of Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, USA.

Abstract

Background: Since there are limited studies on the associations between glycemic variability (GV) and sleep quality or physical activity in subjects without diabetes, we evaluated the associations between GV, as assessed by continuous glucose monitoring (CGM), and both sleep quality and daily steps using wearable devices in healthy individuals.

Methods: Forty participants without diabetes were monitored by both an intermittently scanned CGM and a smartwatch-type activity tracker for 2 weeks. The standard deviation (SD) and coefficient of variation (CV) of glucose were evaluated as indices of GV. The activity tracker was used to calculate each participant's average step count per day. We also calculated sleep duration, sleep efficiency, and sleep latency based on data from the activity tracker. Spearman's correlation coefficient was used to assess the association between GV and sleep indices or daily steps. For each participant, periods were divided into quartiles according to step counts throughout the day. We compared mean parameter differences between the periods of lowest quartile and highest quartile (lower 25% and upper 25%).

Results: SD glucose was significantly positively correlated with sleep latency (R = 0.23, P < 0.05). There were no significant correlations among other indices in GV and sleep quality (P > 0.05). SD glucose and CV glucose levels in the upper 25% period of daily steps were lower than those in the lower 25% period in each participant (both, P < 0.01).

Conclusion: In subjects without diabetes, GV evaluated by intermittently scanned CGM was positively associated with the time to fall asleep. Furthermore, GV in the days of larger daily steps was decreased compared to the days of smaller daily steps in each participant.

Keywords: Glycemic variability; Intermittently scanned continuous glucose monitoring; Sleep quality; Wearable device.