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Original Article

IJMDC. 2020; 4(3): 700-705

Circadian misalignment effect on HbA1c among patients with diabetes

Hyder Osman Mirghani, Sultan Saleh Albalawi, Hosam Hadi Awaji, Abdulrahman Mohammed Naji Alharbi, Ahmed Marwan Alamrani, Saeed Ali Ibrahim Alzahrani, Saud Abdulrahman Saad Alghamdi, Nawaf Musallam Salem Albalawi, Sultanah Faisal Alghabban.


Background: Several research studies have been reporting an association between circadian rhythm and glucose levels. This study was aimed to calculate the prevalence of circadian misalignment in patients with diabetes, to identify the association between sleep parameters and glycemic control, and to investigate its effect on glycemic control, as assessed by hemoglobin a1c (HbA1c).
Methodology: A cross-sectional study was carried out in the Diabetes Outpatient Clinic at the Diabetes Center, King Fahad Specialist Hospital, Tabuk city, Saudi Arabia. A convenient sample includes adult patients of 18 years or older with either type 1 or type 2 diabetes and residents of Tabuk city. Data collection was carried out through a face-to-face interview using a structured questionnaire.
Results: This study included 187 diabetic patients. About one-fourth of them (27.3%) reported skipping breakfast three times or more. The bedtime lag between the weekdays and weekend was more than 2 hours in about half (51.3%) of them. Significantly, there was a higher median HbA1c in patients with a higher number (≥3) of skipped breakfast (8.0 vs. 7.0, respectively, p = 0.006). There was a significant negative association between the calculated bedtime lag between the weekdays and weekend and HbA1c (r = −0.16, p = 0.030).
Conclusion: The findings of this study indicated an association between a circadian misalignment in the form of skipping breakfast ≥3 times/week, bedtime lag between the weekdays and weekends, and poor glycemic control in adult diabetic patients. These findings are expected to contribute to the prevention and risk reduction of complications in diabetic patients.

Key words: Circadian misalignment, HbA1c, diabetes

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