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Diabetology
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Advances in Sleep Disorders in Patients with Diabetes
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Advances in Sleep Disorders in Patients with Diabetes

A special issue of Diabetology (ISSN 2673-4540).

Deadline for manuscript submissions: 20 November 2026 | Viewed by 3634

Editor

Dr. Stephanie A. Griggs

E-Mail Website
Guest Editor
Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
Interests: sleep and circadian science; type 1 diabetes; type 2 diabetes; at risk diabetes; glucose variability; cognitive behavioral clinical trials

Special Issue Information

Dear Colleagues,

The role of sleep and circadian rhythms and their dysfunction or disorders, in the aetiology or management of diabetes, is an emerging area of scientific interest. Based on the convergence of laboratory and epidemiologic studies, sleep loss and circadian misalignment have been indicated as novel risk factors for obesity and type 2 diabetes. Current evidence on specific behavioral and physiological factors contributing to diabetes pathobiology (type 1 diabetes and type 2 diabetes), disease course, treatment response, and novel interventions to improve the effectiveness of diabetes management is essential.

Recent studies have highlighted the potential of interventions targeting sleep deprivation, such as cognitive behavioral therapy for insomnia, or circadian alignment strategies including systematic sleep extension, chronotherapy (bed, meal, drug timing, and light therapy), and other lifestyle modifications, as adjuncts to conventional diabetes treatment. Understanding the intricacies of the sleep-diabetes relationship can lead to innovative approaches for risk assessment, prevention, and management of diabetes. This Special Issue aims to synthesize current knowledge on original research or rigorous reviews of research (e.g., systematic reviews, meta-analysis, integrative reviews) to explore and build on the state of the science on sleep and circadian dysfunction in individuals with or at risk for diabetes (type 1, type 2 diabetes, and at-risk/pre diabetes).

Dr. Stephanie A. Griggs
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diabetology is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • sleep
  • circadian rhythms
  • sleep dysfunction
  • circadian dysfunction
  • diabetes
  • type 1 diabetes
  • type 2 diabetes
  • sleep loss
  • circadian misalignment
  • sleep interventions
  • circadian interventions
  • chronotherapy

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (3 papers)

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Research

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17 pages, 495 KB  
Article
A Thematic Analysis of Sleep Behavior Self-Regulation in Young Adults with Type 1 Diabetes
by Madeline Long, Dayna A. Johnson, Youjeong Kang and Stephanie Alisha Griggs
Diabetology 2026, 7(4), 80; https://doi.org/10.3390/diabetology7040080 - 14 Apr 2026
Viewed by 1407
Abstract
Background/Objectives: Sleep is critical for young adults, particularly those with type 1 diabetes (T1D), who face unique challenges in achieving recommended sleep and diabetes health targets. The purpose of this study guided by the theoretical framework of self-regulation theory is to explore [...] Read more.
Background/Objectives: Sleep is critical for young adults, particularly those with type 1 diabetes (T1D), who face unique challenges in achieving recommended sleep and diabetes health targets. The purpose of this study guided by the theoretical framework of self-regulation theory is to explore how these individuals navigate self-regulatory processes in their sleep behaviors through mechanisms of self-monitoring, self-judgment, and self-evaluation. Methods: A qualitative descriptive design was implemented using semi-structured interviews with 34 young adults (ages 18–30) living with T1D. Data were collected through focused interviews, sleep diaries, actigraphy, and continuous glucose monitoring, followed by thematic analysis to identify sleep behavior self-regulation patterns. Results: Three primary themes were identified: (1) Sleep Behavior Self-Monitoring—highlighting participants’ awareness of their sleep habits and the diabetes-related impacts on these habits; (2) Sleep Behavior Self-Judgment—reflecting how personal and societal standards inform their evaluation of sleep health; (3) Sleep Behavior Self-Evaluation—showing emotional responses associated with sleep out-comes, where good sleep led to positive feelings and motivation, while poor sleep resulted in frustration. Conclusions: Understanding sleep behavior self-regulation among young adults with T1D is crucial for improving sleep health and diabetes management. Targeted interventions incorporating sleep education and self-regulatory strategies may enhance both perceived sleep quality and overall well-being in this population. Full article
(This article belongs to the Special Issue Advances in Sleep Disorders in Patients with Diabetes)
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9 pages, 1436 KB  
Article
Effect of Metformin on Sleep Architecture in Patients with Comorbid Diabetes and Sleep Apnea
by Kristen Masada, Daniel Nguyen and Madhu Varma
Diabetology 2026, 7(4), 75; https://doi.org/10.3390/diabetology7040075 - 7 Apr 2026
Viewed by 1235
Abstract
Background/Objectives: Patients with poor sleep are at high risk of developing type II diabetes mellitus (T2DM). Since T2DM is linked to increased risk of obstructive sleep apnea (OSA), and Metformin is commonly used to treat T2DM, we examined how Metformin affects sleep stages [...] Read more.
Background/Objectives: Patients with poor sleep are at high risk of developing type II diabetes mellitus (T2DM). Since T2DM is linked to increased risk of obstructive sleep apnea (OSA), and Metformin is commonly used to treat T2DM, we examined how Metformin affects sleep stages in patients with concurrent T2DM and OSA-related symptoms of snoring and fatigue. Patients with T2DM on Metformin progressively develop increased insulin resistance associated with sleep disturbances and poor glycemic control. We therefore explored sleep pattern changes in patients with OSA symptoms and T2DM on Metformin, with a special focus on whether Metformin affects sleep architecture. Methods: Polysomnogram (PSG) data from patients with T2DM on Metformin was evaluated along with data on age, body-mass index (BMI), and biological sex. Data analysis included mean ± standard deviation, t-test with p < 0.05 taken as significant, and linear regression. Results: Patients with a BMI of less than 30 (non-obese) and taking Metformin exhibited a significantly shorter rapid eye movement sleep stage (REM) duration than patients on alternative therapies (p = 0.036). No such difference in REM was found for patients with a BMI of 30 or greater (obese) taking Metformin. While there was also no significant difference in slow-wave sleep stage (N3) duration with Metformin use, linear regression identified a moderate negative correlation between N3 and age in patients taking non-Metformin therapies (R2 = 0.4555). No significant correlations between sleep stage duration and patient sex, smoking status, or BMI greater than 30 were identified. Conclusions: Overall, patients with OSA and T2DM on Metformin had lower mean quantities of N3, and REM sleep compared to those not on Metformin. Non-obese patients with T2DM and OSA being treated with Metformin were observed to have less REM sleep, regardless of sex or smoking history. N3 and REM sleep are needed for the timely secretion of growth hormone and memory consolidation. Since Metformin is correlated with differences in N3 and REM sleep, it may contribute to the development of insulin resistance. Future studies are needed to explore potential causes for this relationship and how it may affect the treatment of T2DM. Full article
(This article belongs to the Special Issue Advances in Sleep Disorders in Patients with Diabetes)
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Review

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10 pages, 989 KB  
Review
Management of Obstructive Sleep Apnea in People with Type 2 Diabetes
by Niel Patel, Miriam Soliman, Amit Majithia and Atul Malhotra
Diabetology 2026, 7(7), 128; https://doi.org/10.3390/diabetology7070128 - 3 Jul 2026
Viewed by 433
Abstract
Obstructive sleep apnea (OSA) is a common condition defined by recurrent upper airway collapse, intermittent hypoxia, and sleep fragmentation that leads to sympathetic activation and adverse cardiometabolic effects. OSA and type 2 diabetes mellitus (T2DM) share a complex, bidirectional relationship driven in part [...] Read more.
Obstructive sleep apnea (OSA) is a common condition defined by recurrent upper airway collapse, intermittent hypoxia, and sleep fragmentation that leads to sympathetic activation and adverse cardiometabolic effects. OSA and type 2 diabetes mellitus (T2DM) share a complex, bidirectional relationship driven in part by obesity, but also by overlapping pathophysiologic mechanisms. Diabetes may worsen upper airway collapsibility, while untreated OSA may exacerbate hyperglycemia, contributing to a self-perpetuating cycle of metabolic abnormalities. Continuous positive airway pressure (CPAP) remains the first-line therapy for OSA, and improves symptoms and some cardiometabolic parameters, although effects on glycemic control have been mixed and may depend on patient factors. Alternative therapies play important roles in some patients. Incretin-based therapies, particularly tirzepatide, have emerged as promising treatments for obesity-related OSA following the SURMOUNT-OSA trial, demonstrating significant reductions in apnea–hypopnea index and cardiometabolic risk factors, though their effect in patients with T2DM remains unclear. Considerations such as sarcopenia with weight loss and evolving pharmacologic and procedural strategies further shape management decisions. This review synthesizes current evidence on the pathophysiologic overlap, therapeutic approaches, and future directions in optimizing care for patients with coexisting OSA and diabetes. Full article
(This article belongs to the Special Issue Advances in Sleep Disorders in Patients with Diabetes)
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