| Titre : | SLEEP DEPRIVATION AS A CONTRIBUTING FACTOR TO INSULIN RESISTANCE AND TYPE 2 DIABETES |
| Auteurs : | BOUALI Noura Radjaa, Auteur ; Nasr-Eddine KEBIR, Directeur de thèse |
| Type de document : | texte imprimé |
| Editeur : | Dr. Moulay Tahar Université Saida, Faculté des Sciences Naturelles et de la Vie, 2025/2026 |
| Format : | 105 p / 29 CM |
| Accompagnement : | CD |
| Langues: | Anglais |
| Langues originales: | Anglais |
| Catégories : | |
| Mots-clés: | Sleep deprivation ; Sleep quality ; Insulin resistance ; Type 2 diabetes ; Glycemic control ; HbA1c ; Metabolic risk ; University students ; Sleep fragmentation ; Saïda Algeria |
| Résumé : |
Background: Sleep deprivation is increasingly recognized as a modifiable risk factor for
metabolic disorders. However, its relationship with insulin resistance and type 2 diabetes (T2D) remains insufficiently characterized, particularly among young adults and individuals with established diabetes. Objectives: This study aimed to (1) assess sleep patterns and metabolic risk indicators among university health-science students and (2) evaluate the association between sleep quality and glycemic control in patients with type 2 diabetes. Methods: A cross-sectional descriptive and analytical study was conducted among 196 participants, including 98 university students and 98 patients with T2D, recruited from academic and clinical settings in Saïda, Algeria. Data were collected using two structured questionnaires adapted from the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS), together with sociodemographic, lifestyle, anthropometric, and clinical variables. Results: Among students, 33% reported sleeping fewer than 6 hours per night, 72% experienced nocturnal awakenings, and a substantial proportion presented excess body weight. In the T2D group, 65% had HbA1c levels ≥ 8%, exceeding the American Diabetes Association target of ≤7%, indicating poor glycemic control. Furthermore, 52% of diabetic patients reported elevated blood glucose levels following poor sleep, while sleep fragmentation was highly prevalent in both groups. Overall, sleep disturbances were associated with several metabolic risk factors, including overweight status, reduced physical activity, and impaired glycemic control. Conclusion: The findings highlight a significant association between sleep disturbances and metabolic dysregulation in both at-risk young adults and patients with type 2 diabetes. Sleep quality emerges as an important and potentially modifiable determinant of metabolic health and should be incorporated into preventive strategies and clinical management programs aimed at reducing insulin resistance and improving glycemic control. |
| Note de contenu : |
FRONT MATTER
Dedication....................................................................................................................................... 2 Acknowledgements......................................................................................................................... 3 List of Abbreviations: ..................................................................................................................... 4 Table of contents:............................................................................................................................ 5 Table list: ........................................................................................................................................ 9 Figure list: ..................................................................................................................................... 10 ABSTRACT:................................................................................................................................. 11 11 ............................................................................................................................................ :ملخص RÉSUMÉ : .................................................................................................................................... 12 GENERAL INTRODUCTION 1. .......................................................................................................................................I ntroduction:................................................................................................................................... 14 2. .......................................................................................................................................R esearch problem: ........................................................................................................................... 15 3. .......................................................................................................................................R esearch questions: ......................................................................................................................... 15 4. ....................................................................................................................................... G eneral Hypothesis:......................................................................................................................... 16 5. .......................................................................................................................................C onceptual Definitions:................................................................................................................... 17 PART I: LITERATURE REVIEW CHAPTER 1: PHYSIOLOGY OF SLEEP I.1.1 Definition of Sleep: .............................................................................................................. 20 I.1.2 Sleep Phases: ........................................................................................................................ 21 I.1.2.1 NREM Sleep...................................................................................................................... 21 I.1.2.1.1 NREM Phases................................................................................................................. 21 I.1.2.2 REM Sleep:........................................................................................................................ 22 I.1.3 Sleep Regulation:.................................................................................................................. 24 I.1.3.1 Circadian Regulation ......................................................................................................... 24 I.1.3.2 Hormonal Regulation ........................................................................................................ 24 I.1.3.3 Nervous System Regulation .............................................................................................. 24 I.1.4 Factors Influencing Sleep:.................................................................................................... 24 I.1.4.1 Environmental Factors....................................................................................................... 24 TABLE OF CONTENT 6 I.1.4.2 Behavioral Factors............................................................................................................. 24 I.1.4.3 Stress and Anxiety............................................................................................................. 24 I.1.4.4 Irregular Schedules and Night Work ................................................................................. 25 I.1.5 Sleep Disorders:.................................................................................................................... 25 I.1.5.1 Insomnia ............................................................................................................................ 25 I.1.5.2 Sleep Apnea....................................................................................................................... 25 I.1.5.3 Circadian Rhythm Disorders............................................................................................. 25 I.1.6 Importance of Sleep in Biological Balance: ......................................................................... 25 I.1.6.1 Metabolic Regulation ........................................................................................................ 25 I.1.6.2 Immune Function............................................................................................................... 25 I.1.6.3 Energy Restoration ............................................................................................................ 25 I.1.6.4 Memory Consolidation...................................................................................................... 26 I.1.6.5 Glucose Regulation and Insulin Sensitivity....................................................................... 26 I.1.7 Effects of Sleep Deprivation: ............................................................................................... 26 I.1.7.1 Short-Term Effects............................................................................................................ 26 I.1.7.2 Long-Term Effects ............................................................................................................ 26 I.1.7.3 Hormonal and Metabolic Imbalances................................................................................ 26 I.1.8 Chapter summary.................................................................................................................. 26 CHAPTER 2: DIABETES I.2.1 Type 2 Diabetes and Metabolic Disorders: .......................................................................... 28 I.2.2 Definition and Diagnosis of Diabetes Mellitus: ................................................................... 28 I.2.3 Epidemiology: ...................................................................................................................... 29 I.2.4 Classification of Diabetes Mellitus....................................................................................... 30 I.2.4.1 Type 1 Diabetes................................................................................................................. 30 I.2.4.2 Type 2 Diabetes................................................................................................................. 30 I.2.4.3 Gestational Diabetes.......................................................................................................... 30 I.2.4.4 Other Types of Diabetes.................................................................................................... 30 I.2.5 Pathophysiology of Type 2 Diabetes.................................................................................... 30 I.2.6 Complications....................................................................................................................... 31 I.2.6.1 Microangiopathic Complications ...................................................................................... 31 I.2.6.2 Macroangiopathic Complications...................................................................................... 32 I.2.7 Risk Factors for Type 2 Diabetes......................................................................................... 34 I.2.7.1 Constitutional Factors:....................................................................................................... 34 I.2.7.2 Environmental and Behavioral Factors: ............................................................................ 34 TABLE OF CONTENT 7 I.2.8 Therapeutic Management of Type 2 Diabetic Patients: ....................................................... 34 I.2.8.1 Insulin Therapy:................................................................................................................. 34 I.2.8.2 Oral Antidiabetic Medications: ......................................................................................... 34 I.2.8.3 Lifestyle Modifications and Physical Exercise: ................................................................ 35 I.2.9 Relationship between sleep and type 2 diabetes:.................................................................. 35 I.2.10 Chapter summary............................................................................................................... 35 CHAPTER 3: INSULIN RESISTANCE I.3.1 Introduction: ......................................................................................................................... 37 I.3.2 General Overview of Insulin: ............................................................................................... 37 I.3.2.1 Insulin and Its Receptor:.................................................................................................... 37 I.3.2.2 Insulin Signaling:............................................................................................................... 39 I.3.2.3 Negative Regulation of Insulin Action:............................................................................. 40 I.3.2.4 Involvement of Insulin in Metabolism: ............................................................................. 40 I.3.3 Insulin Resistance ................................................................................................................. 40 I.3.3.1 Definition:.......................................................................................................................... 40 I.3.3.2 Prevalence:......................................................................................................................... 41 I.3.3.3 Stages of Insulin Resistance Progression : ........................................................................ 41 I.3.3.4 Molecular Mechanisms of Insulin Resistance:.................................................................. 41 I.3.3.5 Causes of Insulin Resistance: ............................................................................................ 41 I.3.3.5.1 Lifestyle Factors: ............................................................................................................ 41 I.3.3.5.2 Genetic Factors :............................................................................................................. 42 I.3.3.6 Evaluation of Insulin Resistance: ...................................................................................... 42 I.3.3.7 Prevention and Management of Insulin Resistance:.......................................................... 42 I.3.3.8 Acanthosis Nigricans as an Early Marker of Insulin Resistance:...................................... 43 I.3.3.9 Chapter summary............................................................................................................... 43 PART II: PRACTICAL PART CHAPTER 4:MATERIALS AND METHODS II.4.1 Type and Design of the Study:............................................................................................ 46 II.4.2 Research Objectives:........................................................................................................... 46 II.4.3 Research Hypotheses: ......................................................................................................... 46 II.4.4 Study Population: ................................................................................................................ 47 II.4.5 Data Collection Tool:.......................................................................................................... 47 II.4.6 Variables Studied: ............................................................................................................... 48 II.4.7 Ethical Considerations......................................................................................................... 48 TABLE OF CONTENT 8 CHAPTER 5: RESULTS II.5.1 Sociodemographic Data ...................................................................................................... 50 II.5.2 Sleep Duration..................................................................................................................... 55 II.5.3 Sleep Quality....................................................................................................................... 58 II.5.4 Lifestyle factors................................................................................................................... 60 II.5.5 Anthropometric Measurements........................................................................................... 62 II.5.6 Section 6: Metabolic Data ................................................................................................... 63 II.5.7 Clinical Data........................................................................................................................ 64 II.5.8 Sleep– Glycaemia Relationship .......................................................................................... 72 II.5.9 Blood Sugar Monitoring...................................................................................................... 75 CHAPTER 6: GENERAL DISCUSSION II.6.1 General Discussion of the Results:...................................................................................... 78 II.6.2 Hypothesis Validation Through Results ............................................................................. 79 II.6.3 Study Limitations................................................................................................................ 80 GENERAL CONCLUSION AND RECOMMENDATIONS .......................................................................................................................................................................................R ECOMMENDATIONS: ............................................................................................................... 82 .......................................................................................................................................................................................G ENERAL CONCLUSION:........................................................................................................... 83 REFERANCES BIBLIOGRAPHY:........................................................................................................................ 85 APPENDICES Appendix A:.................................................................................................................................. 90 Appendix B:.................................................................................................................................. 91 |
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