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• W2009696510 abstract "Cover image: ‘African Tears’ by Rebekka Ivacson. © All rights reserved David Hadden sadly died on 26 February 2014. He was an ‘old school’ diabetologist and an internationally respected authority on diabetes and pregnancy. Over the last 4 years he served as technical editor for Diabetic Medicine and despite his illness worked to the end of 2013. He will be truly missed by all those that contribute to Diabetic Medicine. At the European Association for the Study of Diabetes (EASD) 2013 board meeting when he announced his impending retirement from the journal he said that he would be known by the journal for the person who removed abbreviations; we celebrate his life and legacy to people with diabetes. It is well established that there is a relationship between sleep disturbances and insulin resistance 1, with a wealth of evidence to support that sleep disturbances results in decreased insulin sensitivity through the effects of intermittent hypoxaemia and sleep fragmentation. There is some evidence to suggest bidirectionality with hyperinsulinaemia and insulin resistance once established, promoting sleep disturbances arising from diabetic neuropathy and/or ventilatory instability. As metformin exerts its effect on insulin resistance, one might therefore postulate that it could have a beneficial effect on sleep disturbance. This month's highlighted article in this issue of Diabetic Medicine is by Kajbaf and colleagues (page 577). In their short report they describe a relationship between metformin therapy and sleep quantity and quality in patients with Type 2 diabetes. The research is based on a retrospective study of 387 consecutive outpatient referrals with Type 2 diabetes for screening for sleep apnoea syndrome at Amiens University Hospital (France). Two groups were compared; 314 subjects who were metformin treated and 73 subjects who did not take metformin. In the metformin-treated group, total sleep time was longer by 36 min and sleep efficiency was also higher. Importantly, these differences persisted in a multivariate analysis despite a higher BMI in the metformin-treated group. Although the number of insulin-treated patients were similar in both groups (15–17%), more patients not taking metformin were on sulphonylurea therapy (55%) compared with those who were metformin treated (28%). As pointed out by the authors, there are a number of weaknesses of the study, including study design, the low number of people with Type 2 diabetes not being treated with metformin and differences in the number of concomitant anti-diabetic medications. Nonetheless, the data presented require the randomized clinical trial evidence of the benefit of metformin on sleep disturbance in Type 2 diabetes." @default.
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• W2009696510 date "2014-04-14" @default.
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• W2009696510 title "Diabetes, sleep and metformin" @default.
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• W2009696510 doi "https://doi.org/10.1111/dme.12433" @default.
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