| Title | Improvement of glycemic control by treatment for insomnia with suvorexant in type 2 diabetes mellitus. | ||
| Author | Toi, Norikazu; Inaba, Masaaki; Kurajoh, Masafumi; Morioka, Tomoaki; Hayashi, Noriyuki; Hirota, Tomoe; Miyaoka, Daichi; Emoto, Masanori; Yamada, Shinsuke | ||
| Journal | J Clin Transl Endocrinol | Publication Year/Month | 2019-Mar |
| PMID | 30619717 | PMCID | PMC6306692 |
| Affiliation | 1.Department of Metabolism, Endocrinology, and Molecular Medicine, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan. | ||
INTRODUCTION: Acute and chronic insomnia can exacerbate type 2 diabetes mellitus (T2DM). We investigated suvorexant (an anti-insomnia drug that targets the orexin system) effects on sleep architecture and glucose metabolism in T2DM patients with insomnia. MATERIALS AND METHODS: This 7鈥痙ay open-label, single-arm, intervention trial included 18 subjects with T2DM and insomnia. After 1鈥痙ay acclimatization, daily glucose levels, sleep architecture, and autonomic nervous function were evaluated by continuous glucose monitoring (CGM), single-channel electroencephalography, and accelerometry, respectively. RESULTS: Suvorexant treatment for 3鈥痙ays significantly increased total sleep time and sleep efficiency, with partial suppression of sympathetic nerve activity. CGM-measured 24鈥痟 mean glucose level decreased significantly from 157.7鈥?/-鈥?2.9 to 152.3鈥?/-鈥?7.8鈥痬g/dL, especially in the early glucose surge after the midnight nadir (from 28.3鈥?/-鈥?5.0 to 18.2鈥?/-鈥?.9鈥痬g/dL), and until supper with a significant improvement in homeostasis model assessment of insulin resistance from 4.0鈥?/-鈥?.8 to 2.9鈥?/-鈥?.6, respectively. CONCLUSIONS: Suvorexant treatment for insomnia of subjects with T2DM significantly improved CGM-measured daily glycemic control, which was associated with changes in sympathomimetic tone and/or improved insulin sensitivity. The amelioration of insomnia may therefore be a target for improving glycemic control in T2DM patients with insomnia.