Association between sleep disorders and alterations in glucose metabolism, insulin, and glucagon in patients with type 2 diabetes

This retrospective observational study investigated the association between sleep disorders and alterations in glucose metabolism, insulin secretion, and glucagon regulation in patients with type 2 diabetes mellitus (T2DM). A total of 294 patients with T2DM were enrolled between January 2020 and December 2024, including 108 patients with sleep disorders and 186 without. Sleep quality was assessed using the Pittsburgh sleep quality index, with a score >7 indicating poor sleep quality. Clinical and biochemical parameters, including fasting plasma glucose, glycated hemoglobin (HbA1c), serum insulin, and plasma glucagon levels, were analyzed. An oral glucose tolerance test was conducted to evaluate dynamic changes in insulin and glucagon secretion. Compared with patients without sleep disorders, those with poor sleep quality exhibited significantly higher fasting plasma glucose, 2-hour plasma glucose, HbA1c, and homeostasis model assessment of insulin resistance (HOMA-IR) values, alongside lower homeostasis model assessment of β-cell function (HOMA-β) (all P <.001). During oral glucose tolerance test, insulin responses were attenuated, and glucagon concentrations remained consistently higher with insufficient suppression at postload time points in the sleep-disorder group. These results indicate that sleep disturbances are closely linked to increased insulin resistance, impaired β-cell function, and dysregulated α-cell activity, poor sleep quality was associated with impaired glucose metabolism.