Evidence map›Paper›PMID 40512259›Full record

ArticleSleep & breathing = Schlaf & Atmung2025

Poor sleep quality is a predictor of severe hypoglycemia during comprehensive diabetes care in type 1 diabetes.

Prapai Dejkhamron, Thipaporn Tharavanij, Supawadee Likitmaskul, Petch Rawdaree, Jeerunda Santiprabhob, Chaicharn Deerochanawong, Wannee Nitiyanant, Sirimon Reutrakul, Thai-Type 1 Diabetes and Diabetes diagnosed Age before 30 years Registry, Care and Network (T1DDAR CN) committee and members

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In one paragraph

Article in Sleep & breathing = Schlaf & Atmung, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Prapai DejkhamronDepartment of Pediatrics, and Northern Diabetes Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Thipaporn TharavanijDepartment of Medicine, Faculty of Medicine, Center of Excellence in Applied Epidemiology, Center of Excellence in Nexus for Advanced Intelligence in Law, Engineering, and Medicine (Nail'Em), Thammasat University and Thammasat Diabetes Center of Excellence, Thammasat University Hospital, Pathumthani, Thailand.
Supawadee LikitmaskulSiriraj Diabetes Center of Excellence and Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Petch RawdareeDepartment of Medicine, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand.
Jeerunda SantiprabhobSiriraj Diabetes Center of Excellence and Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Chaicharn DeerochanawongRajavithi Hospital and Department of Medicine, College of Medicine, Rangsit University, Pathumthani, Thailand.
Wannee NitiyanantSiriraj Diabetes Center of Excellence and Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Sirimon ReutrakulDivision of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. sreutrak@uic.edu.ORCID 0000-0002-0686-1069
Thai-Type 1 Diabetes and Diabetes diagnosed Age before 30 years Registry, Care and Network (T1DDAR CN) committee and members

Funding

Diabetes Association of Thailand Diabetes Association of ThailandHealth Systems Research Institute Health Systems Research InstituteNational Health Security Office National Health Security OfficeThai Society for Pediatric Endocrinology Thai Society for Pediatric Endocrinology
6 · The paper itself

Abstract

purposeSleep disturbances is common in type 1 diabetes (T1D) and can be associated with poor glycemic control, and possibly hypoglycemia. This study aims to investigate whether poor sleep quality, as assessed by the Pittsburgh Sleep Quality Index (PSQI), was associated with glycemic control or severe hypoglycemia in T1D individuals.

methodsThis one-year prospective cohort study included 221 (148 F/63 M) T1D participants (aged ≥ 13 years), receiving intensive insulin therapy. A1C levels were obtained at baseline and during the 12-month follow-up. Incidences of diabetic ketoacidosis (DKA) and severe hypoglycemia were collected.

resultsThe mean age of participants was 21.4 ± 8.9 years, with a baseline A1C of 9.27 ± 2.61%. Poor sleep quality was reported in 33.0% of participants. A1C levels improved over the one-year follow-up, but there was no significant difference in A1C reduction between those with good vs. poor sleep quality (-0.42 ± 1.73 vs. -0.42 ± 1.67, P = 0.835), nor in DKA incidence (P = 0.466). However, participants with poor sleep quality experienced more SH episodes (6.53 (2.45-17.41) vs. 0 per 100-person year, P = 0.01). After adjusting for age, body mass index, and glucose monitoring, each one-point increase in PSQI score was associated with a higher severe hypoglycemia risk (OR 1.31, 95%CI 1.13-1.52). Poor sleep quality predicted an increased risk of severe hypoglycemia (OR 24.54, 95%CI 1.31-459.29).

conclusionPoor sleep quality is common in T1D individuals and is a risk factor for incident SH. These findings highlight the importance of incorporating sleep assessment into routine T1D diabetes care and the need of targeted interventions to improve sleep quality in T1D individuals. These findings support the importance of addressing sleep quality in T1D management, particularly in relation to hypoglycemia risk.

Indexed as

Diabetes Mellitus, Type 1HypoglycemiaSleep QualitySleep Wake DisordersAdolescentAdultFemaleGlycated HemoglobinHumansHypoglycemic AgentsInsulinMaleProspective StudiesYoung AdultGlycated HemoglobinHypoglycemic AgentsInsulinHypoglycemiaSleep qualityType 1 diabetes

Identifiers

PMID40512259
PMCPMC12165869

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.