Type 2 diabetes, which is now the seventh leading cause of death in the United States, is a dangerous condition that can lead to heart disease, amputation, kidney failure, and blindness.
The missing link in diabetes prevention
Most of the time, when someone is diagnosed with prediabetes or with Type 2 Diabetes, recommendations are to lose weight, and workout. Easier said than done! These recommendations are perfectly sound, but they are not always helpful, they are far from sufficient, and they sometimes actually cause more damage than good.
First of all, if it were that easy to lose weight and find time to be more active, we would all do it without being told to. Unfortunately, it can be very difficult to live a healthier lifestyle considering how busy we are and also considering that everything and its opposite is available on the internet when it comes to the best ways to lose weight.
When adults feel lost and can’t manage to follow their doctor’s recommendations because they can't achieve weight loss, they feel like failure, are convinced that they are weak, they lose self-esteem and they keep blaming themselves for shortcomings that are actually not theirs.
Furthermore, even if losing weight is indeed often needed to improve blood sugar levels, what is probably even more important is HOW we lose the weight.
I have seen clients who had been on all kinds of diets before working with me in order to improve their blood sugar. And the diets worked… for a while! Until their cholesterol levels sky rocketed, their blood pressure too, and eventually, their blood sugar got worse than before the various regimen. They would lose weight, yes, but then they would fall off the wagon and gain it all back... and some more.
Why is that? Because losing weight in itself is not sufficient. We need to do it in a healthy manner, making long-term results top priority, rather than focusing on fast weight loss at any price.
Sleep: key player in blood sugar control
There is another reason why suggesting to patients that they lose weight and workout is not sufficient to help them improve their blood sugar.
There is indeed another critical element in the fight against Type 2 Diabetes. And that critical element is SLEEP.
Studies have shown that sleep deprivation can increase a person's chances of having type 2 diabetes, because sleep deprivation causes two critical metabolic changes in the human body:
- a decrease in glucose tolerance;
- an increase in insulin resistance.
Glucose intolerance (which is the result of our glucose tolerance going down) and insulin resistance are syndromes predisposing to type 2 diabetes and the reason researchers now “urge clinicians to recommend at least seven hours of uninterrupted sleep per night as part of a healthy lifestyle.”
How sleep affects sugar metabolism
It’s been found that when someone is chronically sleep-deprived, their body releases less insulin when they eat. Insulin is the hormone that allows glucose (blood sugar) to enter our cells and provide them with energy. If there is not enough insulin released when we eat, glucose accumulates in our blood.
Lack of sleep also leads to our body releasing more stress hormones, such as cortisol. Cortisol, though it creates a sense of “awakeness,” also makes insulin less effective.
As a result, a chronically sleep-deprived person releases less insulin, and this insulin is not as efficient as it should be.
The consequences are huge: glucose accumulates in our blood and can damage our blood vessels, starting with the smallest ones. The parts of our body that have the smallest vessels (capillaries) usually suffer first from diabetes: our eyes, kidneys, and the nervous system. This is why complications from type 2 diabetes include blindness, peripheral neuropathy, and permanent kidney damage.
Interestingly enough, these side effects have been observed not just for those who sleep very little, but also for those who sleep six hours per night. Think about it: if we go to bed at 10 pm, read for a while, and then wake up twice during the night before getting up at 6 am the next day, chances are we will sleep about six hours each night.
Sleeping six hours is not unusual for most people, and this less obvious lack of sleep negatively affects our ability to maintain proper insulin sensitivity and blood sugar management.
How much sleep do I need?
When it comes to the ideal sleep duration, it seems that the lowest risk for type 2 diabetes is at seven to eight hours of sleep per day, according to a study looking at 482,502 participants for 2.5 to 16 years.
Unfortunately, the link between lack of sleep and prediabetes or type 2 diabetes is often overlooked. When trying to reverse prediabetes or improve blood sugar levels, we tend to focus our efforts on weight loss, nutrition, and exercise, and we completely ignore sleep.
This is a colossal mistake, but one that can be corrected easily.
I regularly work with clients who have been diagnosed with prediabetes. When they come to me, they explain that their doctor had recommended a healthier diet and more physical activity. These are well-intentioned recommendations, but what I often witness is that my clients are too busy to incorporate healthy homemade meals and regular workouts in their lifestyle, unless they do it in a very strategic way.
Often, when they come to see me, they have already cut into their sleep time in order to try and fit these new "healthy lifestyle chores" in their busy schedule. Sleep seems to be the only thing that they could reduce without apparent side effects, thanks to coffee, energy drinks, and sugary snacks. Unfortunately, they are sleep-deprived - sometimes without being aware of it - and they haven't got the results they were hoping for regarding their blood sugar levels and their weight.
When we start working together, we take a look at their lifestyle as a whole. This holistic approach, with an emphasis on balance, pleasure, and harmony, is the only way, in my opinion, to implement lifestyle changes that will be efficient but also sustainable.
To conquer type 2 diabetes, we have to consider each person as a whole, and we have to keep in mind that sleep is a productive part of our life, not just wasted hours doing nothing.