Children and young people with type 1 diabetes and sleep disturbances thrive less well than their healthy peers

There are no Danish studies on the importance of sleep for either diabetes management or achieving the treatment goal. However, there does seem to be a clear trend. Children and young people with type 1 diabetes and sleep disturbances thrive less well than their healthy peers.

Cecilie Paulsrud, at the Department of Paediatrics at Herlev and Gentofte Hospital, has now been given the opportunity both to document the situation and to do something about this problem. She has received a grant from the Danish Diabetes Academy for a PhD entitled ‘The importance of sleep-associated tasks and outcomes’.

“As a result of poorer memory and planning, and impaired attention and learning, sleep disorders can potentially affect a person’s ability to manage diabetes optimally.”

The ultimate goal of the PhD is to identify a possible method of treatment (optimisation of sleep hygiene, diabetes treatment and racing thoughts) to improve the sleep of children and young people with type 1 diabetes. “The method can be adapted to suit the particular person. It doesn’t require any profound psychological insight on the part of the therapist, nor is it particularly time-consuming. That means it can easily be implemented in the clinic,” Cecilie Paulsrud says.

She will also arrive at a valid estimate of how many children and young people with type 1 diabetes experience sleep disturbances, and what kinds of disturbances they have, while clarifying how poor sleep impacts diabetes management and treatment outcomes in both the short term (day-to-day) and the long term (months/years).

The knowledge, on which her work is based, includes:

• Questionnaire data from 2017 and 2020/21 and actigraph data from the latter period, which reveal a correlation between poor sleep and clinically-relevant higher HbA1c levels in Danish children and young people.
• Despite major technological advances in the treatment of type 1 diabetes (insulin pumps and continuous glucose monitors), 50% of the young people do not achieve the treatment goal. There is a correlation between diabetes management – measured, for example, as the number of measurements of blood sugar and bolus insulin release – and success in achieving the treatment goal. Those who do not achieve their treatment goal are at greater risk of late complications and of psychiatric disorders such as anxiety and depression.
• ‘Danskernes Sundhed – Den Nationale Sundhedsprofil 2017’ (The Health of People in Denmark – The National Health Profile 2017) reported that approximately 15% of young people between the ages of 16 and 24 suffered from sleep disorders. That was an increase of 33.3% since the first survey that was conducted in 2010.
• In Denmark, around 4,000 children and young people (<18 years) live with type 1 diabetes, and they seem to experience more sleep disorders than the background population.
• As a result of poorer memory and planning, and impaired attention and learning, sleep disorders can potentially affect a person’s ability to manage diabetes optimally.
• Only a few international studies have examined the correlation between sleep and metabolic control. However, there seems to be a clear trend that children and young people with type 1 diabetes and sleep disorders also have higher HbA1c and thrive less well.
  

Facts
Cecilie Paulsrud, MD
Awarded DKK 1.1 million by the Danish Diabetes Academy
Project title: The importance of sleep for associated tasks and outcomes
Research institution: Department of Paediatrics, Herlev and Gentofte Hospital
Supervisor: Associate Professor Jannet Svensson, MD, PhD, Department of Paediatrics, Herlev and Gentofte Hospital

Contact
Cecilie Paulsrud
E-mail: cecpaulsrud@gmail.com
Tel: + 45 31 95 83 73
https://www.linkedin.com/in/cecilie-paulsrud-2b5b38204/

Danish Diabetes Academy
Managing Director Tore Christiansen
E-mail: tore.christiansen@rsyd.dk
Tel: +45 29 64 67 64