The Impact of Sleep Quality on Glycemic Control in Type 1 Diabetes: A Retrospective Study in Cohort Using Advanced Technological Devices

Introduction/Aim: Type 1 Diabetes (T1D) challenges glycemic control, with sleep dis-turbances affecting insulin sensitivity and glucose variability. This study aims to assess sleep quality in T1D patients and its impact on glycemic outcomes, particularly at bed-time. Methods: This retrospective observational study, conducted at an Italian clinical center, included T1D patients using Medtronic devices. Sleep quality was assessed us-ing the Italian version of the Pittsburgh Sleep Quality Index (PSQI), and glycemic out-comes were analyzed with CGM data. Statistical comparisons were made using de-scriptive statistics and non-parametric tests. Results: Of 45 patients, 4 were excluded, leaving 41 for analysis. The mean PSQI score was 6.0 ± 4.1, with 36.6% showing poor sleep quality. No significant differences in age, sex, BMI, or diabetes duration were found. Poor sleepers had higher Time in Elevated Glycemic Range 2 (TAR2) (6.3 ± 6.2%) compared to good sleepers (4.1 ± 5.0%). During bedtime hours, poor sleepers showed significantly higher TAR2 (6.7 ± 7.2% vs. 3.3 ± 6.2%, p = 0.013). Conclusions: Improving sleep quality may boost glycemic control and prevent nocturnal hyperglycemia. Future research should focus on sleep interventions in diabetes care.