Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)

Diabetes Care, Год журнала: 2022, Номер 45(11), С. 2753 - 2786

Опубликована: Сен. 23, 2022

The American Diabetes Association and the European for Study of convened a panel to update previous consensus statements on management hyperglycemia in type 2 diabetes adults, published since 2006 last updated 2019. target audience is full spectrum professional health care team providing U.S. Europe. A systematic examination publications 2018 informed new recommendations. These include additional focus social determinants health, system, physical activity behaviors, including sleep. There greater emphasis weight as part holistic approach management. results cardiovascular kidney outcomes trials involving sodium–glucose cotransporter inhibitors glucagon-like peptide 1 receptor agonists, assessment subgroups, inform broader recommendations cardiorenal protection people with at high risk disease. After summary listing recommendations, practical tips implementation are provided.

Язык: Английский

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Management of hyperglycaemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)

Diabetologia, Год журнала: 2022, Номер 65(12), С. 1925 - 1966

Опубликована: Сен. 23, 2022

Язык: Английский

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Measuring sleep regularity: theoretical properties and practical usage of existing metrics

SLEEP, Год журнала: 2021, Номер 44(10)

Опубликована: Апрель 17, 2021

Sleep regularity predicts many health-related outcomes. Currently, however, there is no systematic approach to measuring sleep regularity. Traditionally, metrics have assessed deviations in patterns from an individual's average; these traditional include intra-individual standard deviation (StDev), interdaily stability (IS), and social jet lag (SJL). Two were recently proposed that instead measure variability between consecutive days: composite phase (CPD) index (SRI). Using large-scale simulations, we investigated the theoretical properties of five metrics.

Язык: Английский

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Sleep regularity is a stronger predictor of mortality risk than sleep duration: A prospective cohort study

SLEEP, Год журнала: 2023, Номер 47(1)

Опубликована: Сен. 21, 2023

Abstract Abnormally short and long sleep are associated with premature mortality, achieving optimal duration has been the focus of health guidelines. Emerging research demonstrates that regularity, day-to-day consistency sleep–wake timing, can be a stronger predictor for some outcomes than duration. The role regularity in however, not investigated large cohort objective data. We therefore aimed to compare how predicted risk all-cause cause-specific mortality. calculated Sleep Regularity Index (SRI) scores from > 10 million hours accelerometer data 60 977 UK Biobank participants (62.8 ± 7.8 years, 55.0% female, median[IQR] SRI: 81.0[73.8–86.3]). Mortality was reported up years after recording 1859 (4.84 deaths per 1000 person-years, mean (±SD) follow-up 6.30 0.83 years). Higher 20%–48% lower mortality (p < .001 p = 0.004), 16%–39% cancer 0.001 0.017), 22%–57% cardiometabolic 0.048), across top four SRI quintiles compared least regular quintile. Results were adjusted age, sex, ethnicity, sociodemographic, lifestyle, factors. duration, by comparing equivalent models, nested SRI-mortality models without 0.14–0.20). These findings indicate is an important may simple, effective target improving general survival.

Язык: Английский

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Redefining Cardiovascular Health to Include Sleep: Prospective Associations With Cardiovascular Disease in the MESA Sleep Study

Journal of the American Heart Association, Год журнала: 2022, Номер 11(21)

Опубликована: Окт. 19, 2022

Background Although sufficient and healthy sleep is inversely associated with cardiovascular disease (CVD) its risk factors, the American Heart Association's Life's Simple 7 (LS7), as a measure of health (CVH), did not include sleep. We evaluated an expanded CVH that includes eighth metric in relation to CVD risk. Methods Results The analytic sample consisted MESA (Multi-Ethnic Study Atherosclerosis) Sleep participants who had complete data on characteristics from overnight polysomnography, 7-day wrist actigraphy, validated questionnaires, outcome. computed LS7 score 4 iterations new score: 1 included duration, 2 linked literature (sleep insomnia, daytime sleepiness, obstructive apnea), scores 3 (score 3: duration efficiency, apnea; 4: 3+sleep regularity). Multivariable-adjusted logistic Cox proportional hazards models associations prevalence incidence. Among 1920 (mean age: 69±9 years; 54% female), there were 95 prevalent events 93 incident cases follow-up, 4.4 years). Those highest versus lowest tertile up 80% lower odds CVD. was significantly incidence (hazard ratio, 0.62 [95% CI, 0.37-1.04]). 1, which 4, multidimensional health, 43% 47% 0.57 0.33-0.97]; hazard 0.53 0.32-0.89]), respectively. Conclusions predicted older US adults. incorporation metric, akin other behaviors, may enhance primordial primary prevention efforts. Findings warrant confirmation larger cohorts over longer follow-up.

Язык: Английский

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Sleep Irregularity and Subclinical Markers of Cardiovascular Disease: The Multi‐Ethnic Study of Atherosclerosis

Journal of the American Heart Association, Год журнала: 2023, Номер 12(4)

Опубликована: Фев. 21, 2023

Background Sleep irregularity has been linked to incident cardiovascular disease. Less is known about associations of sleep regularity with atherosclerosis. We examined cross‐sectional actigraphy‐assessed duration and timing subclinical atherosclerosis in the community‐based MESA (Multi‐Ethnic Study Atherosclerosis). Methods Results Ancillary participants (N=2032; mean age, 68.6±9.2 years; 37.9% White) completed 7‐day wrist actigraphy. Participants underwent assessments coronary artery calcium, carotid plaque presence, intima‐media thickness, ankle‐brachial index. was quantified by with‐in person SD onset timing. Relative risk regression models were used calculate prevalence ratios 95% CIs. Models are adjusted for demographics, disease factors, other objectively assessed characteristics including obstructive apnea, duration, fragmentation. After adjustment, compared more regular durations (SD ≤60 minutes), greater >120 minutes) likely have high calcium burden (>300; ratio, 1.33 [95% CI, 1.03–1.71]) abnormal index (<0.9; 1.75 1.03–2.95]). Compared ≤30 irregular >90 (prevalence 1.39 1.07–1.82]). Associations persisted after adjustment factors average Conclusions irregularity, particularly associated several measures may be a modifiable target reducing risk. Future investigation into reduction interventions targeting warranted.

Язык: Английский

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Sleep patterns and risk of chronic disease as measured by long-term monitoring with commercial wearable devices in the All of Us Research Program

Nature Medicine, Год журнала: 2024, Номер 30(9), С. 2648 - 2656

Опубликована: Июль 19, 2024

Abstract Poor sleep health is associated with increased all-cause mortality and incidence of many chronic conditions. Previous studies have relied on cross-sectional self-reported survey data or polysomnograms, which limitations respect to granularity, sample size longitudinal information. Here, using objectively measured, from commercial wearable devices linked electronic record the All Us Research Program, we show that patterns, including stages, duration regularity, are disease incidence. Of 6,785 participants included in this study, 71% were female, 84% self-identified as white had a college degree; median age was 50.2 years (interquartile range = 35.7, 61.5) monitoring period 4.5 (2.5, 6.5). We found rapid eye movement deep inversely odds incident atrial fibrillation irregularity obesity, hyperlipidemia, hypertension, major depressive disorder generalized anxiety disorder. Moreover, J-shaped associations observed between average daily These findings regularity all important factors development may inform evidence-based recommendations healthy sleeping habits.

Язык: Английский

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Associations between sleep variability and cardiometabolic health: A systematic review

Sleep Medicine Reviews, Год журнала: 2022, Номер 66, С. 101688 - 101688

Опубликована: Авг. 21, 2022

Язык: Английский

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Sleep Irregularity Is Associated With Hypertension: Findings From Over 2 Million Nights With a Large Global Population Sample

Hypertension, Год журнала: 2023, Номер 80(5), С. 1117 - 1126

Опубликована: Март 28, 2023

Irregularities in sleep duration and timing have emerged as potential risk factors for hypertension. This study examined associations between irregularity with hypertension a large, global sample over multiple months.Data from 12 287 adults, who used an under-mattress device to monitor also provided blood pressure recordings on ≥5 separate occasions, were analyzed. Sleep was assessed the SD total time across ≈9-month recording period. SDs onset time, midpoint, offset time. Logistic regressions conducted investigate hypertension, defined median systolic ≥140 mm Hg or diastolic ≥90 Hg.Participants middle-aged (mean±SD, 50±12 years), mostly men (88%) overweight (body mass index, 28±6 kg/m-2). consistently associated ≈9% 17% increase independently of A ≈34-minute 32% (1.32 [1.20-1.45]). 32-minute midpoint 18% (1.18 [1.09-1.29]), while 43-minute 8.9% (1.09 [1.001-1.18]).These findings support that irregularity, both timing, is marker poor cardiovascular health. Further mechanistic investigations temporal relationships day-to-day fluctuations next-day pressure, other outcomes are warranted.

Язык: Английский

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Sleep variability and regularity as contributors to obesity and cardiometabolic health in adolescence

Obesity, Год журнала: 2023, Номер 31(3), С. 597 - 614

Опубликована: Фев. 8, 2023

Abstract Objective Adolescence is a developmental stage of critical changes in sleep and its circadian timing when the contribution abnormal variability (amount) regularity (timing) to obesity associated adverse cardiometabolic health outcomes appears increase. The aim this study was summarize findings from studies conducted adolescents examining both relation health. Gaps research potential causal pathways that future should examine are highlighted. Results Nightly deviations duration midpoint appear contribute development youth. Studies show increased irregularity with obesity, decreased physical activity, dysregulated eating inadequate diet, metabolic dysfunction, impaired cardiac autonomic balance, elevated blood pressure adolescents. Conclusions A stable essential overall well‐being Emerging evidence supports misalignment, including irregularity, obesity‐related early on adolescence. Future focus underlying behavioral biological mechanisms pathway between day‐to‐day amount obesity.

Язык: Английский

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