Diabetes, sleep disorders and risk of depression - A Danish register-based cohort study

The effect of light therapy on insomnia: A systematic review and meta-analysis

PURPOSE

Light is a crucial factor influencing sleep arousal patterns. This meta-analysis investigates the efficacy of light therapy (LT) for insomnia treatment.

METHODS

Five electronic databases were independently searched by two reviewers until August 2024. The literature screening focused specifically on populations with insomnia complaints treated by LT. Weighted Mean Difference (WMD) and 95% Confidence Interval (CI) were used as statistical tools, while the Cochrane Risk of Bias tool version 2 (RoB 2) was employed to assess the quality of evidence. A total of 10 randomized controlled trials (RCTs) were analyzed.

RESULTS

The results demonstrated that LT showed statistically significant improvements in subjective sleep quality, as evidenced by a reduction in Pittsburgh sleep quality scale (PSQI) scores by -2.89 (95% CI = -4.80 to -0.97) and Insomnia severity index (ISI) scores by -2.16 (95% CI = -4.23 to -0.08) post-intervention. Additionally, actigraphy revealed a statistically significant increase in total sleep time (TST) by 16.78 min (95% CI = 0.67 to 32.89) and a decrease in wake after sleep onset (WASO) by -12.91 min (95% CI = -25.62 to -0.20) by LT.

CONCLUSION

The preliminary results of the study suggest that LT has some efficacy in improving sleep quality in insomnia. However, it needs to be validated in future clinical trials with larger samples.

The p66Shc Redox Protein and the Emerging Complications of Diabetes

Diabetes mellitus is a chronic metabolic disease, the prevalence of which is constantly increasing worldwide. It is often burdened by disabling comorbidities that reduce the quality and expectancy of life of the affected individuals. The traditional complications of diabetes are generally described as macrovascular complications (e.g., coronary heart disease, peripheral arterial disease, and stroke), and microvascular complications (e.g., diabetic kidney disease, retinopathy, and neuropathy). Recently, due to advances in diabetes management and the increased life expectancy of diabetic patients, a strong correlation between diabetes and other pathological conditions (such as liver diseases, cancer, neurodegenerative diseases, cognitive impairments, and sleep disorders) has emerged. Therefore, these comorbidities have been proposed as emerging complications of diabetes. P66Shc is a redox protein that plays a role in oxidative stress, apoptosis, glucose metabolism, and cellular aging. It can be regulated by various stressful stimuli typical of the diabetic milieu and is involved in various types of organ and tissue damage under diabetic conditions. Although its role in the pathogenesis of diabetes remains controversial, there is strong evidence regarding the involvement of p66Shc in the traditional complications of diabetes. In this review, we will summarize the evidence supporting the role of p66Shc in the pathogenesis of diabetes and its complications, focusing for the first time on the emerging complications of diabetes.

Mediating effects of depression on sleep disturbance and frailty in older adult type 2 diabetes patients in the community

Introduction

With the progressive aging of the population, frailty is now a significant challenge in geriatrics research. A growing amount of evidence suggests that sleep disturbance and depression have independent effects on frailty, although the underlying mechanisms are not yet clear. This study aimed to investigate the mediating role of depression in the relationship between sleep disturbance and frailty in older adult patients with type 2 diabetes (T2DM) in the community.

Method

Purposive sampling was used to collect face-to-face data from 342 community-dwelling T2DM patients in Chengdu, Sichuan Province, China, between February and May 2023. The Pittsburgh Sleep Quality Index (PSQI) scale was used to evaluate sleep quality, the Simple Geriatric Depression Scale (GDS-15) was used to evaluate depressive symptoms, and the FRAIL Scale (FRAIL) was used to evaluate frailty. Linear regression equation and bootstrap self-sampling were used to verify the mediating role of depressive symptoms in sleep disturbance and frailty.

Result

The study found that sleep disturbance had a direct positive effect with frailty [β = 0.040, 95% CI: (0.013, 0.069)]. Additionally, depression had a direct positive effect on frailty [β = 0.130, 95% CI: (0.087, 0.173)], and depression was found to partially mediate the relationship between sleep disturbance and frailty.

Conclusion

Poor sleep quality and frailty are common in patients with T2DM. To reduce the frailty of older adult T2DM patients, all levels of society (government, medical institutions, and communities) must pay more attention to mental health. A variety of interventions should be considered to improve sleep quality and depression, which in turn may prevent or control frailty.