Nocturia and Diabetes

Jeremy Gilbert, MD, FRCPC

Assistant Professor, University of Toronto, Endocrinologist, Sunnybrook Health Sciences Centre, Toronto, ON.


CLINICAL TOOLS

Abstract: Reduced sleep duration and quality can affect slow wave sleep (SWS) or restorative sleep, which is associated with an increased risk of developing type 2 diabetes mellitus. In patients who have been diagnosed with type 2 diabetes mellitus, treating nocturia and the associated deterioration of sleep duration and quality is particularly important to avoid the worsening of symptoms and the potential development of serious complications. Low-dose sublingual desmopressin (25 µg for adult women or 50 µg for adult men) has proven effective in reducing nocturia with the goal of improving SWS.
Key Words: type 2 diabetes mellitus (T2DM), sleep duration, sleep quality, sleep hygiene, slow wave sleep (SWS), optimal glycemic control, desmopressin.

Type 2 diabetes mellitus (T2DM) is an increasingly common chronic disorder.
Type 2 diabetes mellitus (T2DM) rates have risen in recent years in proportion to rising obesity rates, increasing BMIs, and ever more sedentary adult populations.
Research has demonstrated that reduced sleep duration and quality can affect slow-wave sleep (SWS), which is associated with an increase to the risk of developing type 2 diabetes mellitus.
In patients with type 2 diabetes mellitus, treating nocturia and deteriorated sleep duration and quality may be useful to reduce symptoms of hyperglycemia and potentially reduce the development of serious complications.
The initiation of SWS coincides with the hormonal changes that affect glucose regulation.
When researchers supressed SWS in young, healthy, adult participants, they found a significant decrease in insulin sensitivity.
Low-dose sublingual desmopressin (25 µg for adult women or 50 µg for adult men), in addition to optimal glycemic control, has proven effective in reducing nocturia in patients with type 2 diabetes mellitus.
When nocturia events are decreased or eliminated, SWS is improved.
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Disclaimer: 
This article was published as part of THE LATEST IN THE DIAGNOSIS AND MANAGEMENT OF NOCTURIA eCME resource. The development of THE LATEST IN THE DIAGNOSIS AND MANAGEMENT OF NOCTURIA eCME resource was supported by an educational grant from Ferring Inc.