College of Nursing, University of Illinois at Chicago, Chicago, IL, USA.
College of Medicine, University of Illinois at Chicago, Chicago, IL, USA.
J Clin Nurs. 2017 Dec;26(23-24):4053-4064. doi: 10.1111/jocn.13899. Epub 2017 Jul 17.
To explore and synthesise current research to assess the state of science about the relationship between sleep disturbance and glycaemic control in adults with type 2 diabetes.
Sleep disturbance is suggested a risk factor for type 2 diabetes. Diabetes alone is a leading cause of death, but when coupled with sleep disturbance poses additional health risks. However, little is known about the relationship between sleep disturbance and glycaemic control in people with overt diabetes.
An integrative review.
Whittemore and Knafl's methodology guided this integrative review. Original studies published before October 2016 were identified through systematic searches of seven databases using terms: diabet*; sleep or insomnia; glycem* or glucose or A1C or HbA1c or sugar; and their combinations. The matrix and narrative synthesis were employed to organise and synthesise the findings, respectively. The Crowe Critical Appraisal Tool was used to evaluate the study quality.
A total of 26 studies were identified; 17 of which reported significant relationships between sleep measures and glycaemic control. In 13 studies, sleep duration was associated with glycaemic control in both linear (n = 2) and nonlinear (n = 3) relationships; however, eight studies reported no significant relationships. Sleep quality was significantly related to glycaemic control in 14 of 22 studies. Nine studies found no relationship between any measure of sleep and glycaemic control.
There is strong evidence supporting the relationship between sleep quality and glycaemic control but further examination of the relationship between sleep duration and glycaemic control is warranted. Sleep disturbance, particularly impaired sleep quality, could potentially influence glycaemic control in adults with type 2 diabetes.
Nurses who treat patients with diabetes should include assessment of sleep, education for healthy sleep, and referral for treatment of sleep disturbance in order to maximise the potential for achieving good glycaemic control.
探索和综合当前研究，评估成人 2 型糖尿病患者睡眠障碍与血糖控制之间关系的研究现状。
睡眠障碍被认为是 2 型糖尿病的一个危险因素。糖尿病本身是导致死亡的主要原因，但当与睡眠障碍并存时，会带来额外的健康风险。然而，对于显性糖尿病患者，睡眠障碍与血糖控制之间的关系知之甚少。
综合回顾。
Whittemore 和 Knafl 的方法指导了本次综合回顾。通过系统搜索七个数据库，使用术语：糖尿病；睡眠或失眠；糖或葡萄糖或 A1C 或 HbA1c 或糖；及其组合，确定了 2016 年 10 月前发表的原始研究。矩阵和叙述性综合分别用于组织和综合研究结果。使用 Crowe 批判性评估工具评估研究质量。
共确定了 26 项研究；其中 17 项研究报告了睡眠测量与血糖控制之间的显著关系。在 13 项研究中，睡眠时间与血糖控制呈线性（n=2）和非线性（n=3）关系相关；然而，8 项研究则没有显著的关系。在 22 项研究中有 14 项报告睡眠质量与血糖控制显著相关。9 项研究发现任何睡眠测量指标与血糖控制均无关系。
有强有力的证据支持睡眠质量与血糖控制之间的关系，但进一步研究睡眠时间与血糖控制之间的关系是有必要的。睡眠障碍，尤其是睡眠质量差，可能会影响 2 型糖尿病成人的血糖控制。
治疗糖尿病患者的护士应评估睡眠、提供健康睡眠教育，并转介治疗睡眠障碍，以最大程度地实现良好的血糖控制。
