Insomnia is common in patients with T2DM and may adversely affect glycemic control. A cross-sectional study published in the Journal of Diabetes Research examined the association between hypnotic use and glycemic variability using CGM data.

The study enrolled patients with T2DM who underwent CGM between June 1, 2017, and February 28, 2022. Participants were classified into six groups based on insomnia status and hypnotic use: noninsomnia, hypnotic nonusers, BZD users, non-BZD users, ORA users, and MRA users. Glycemic variability was assessed using the standard deviation (SD) of glucose, the coefficient of variation (CV) of glucose, and the mean of daily difference (MODD). Independent associations were evaluated using multiple linear regression.

A total of 534 patients were included in the analysis, with a mean age of 67.7 ± 10.1 years and a mean diabetes duration of 14.5 ± 8.4 years. Thirty-seven patients (6.9%) used hypnotics, including BZD (n = 13), non-BZD (n = 10), ORA (n = 11), and MRA (n = 3).

SD was significantly higher in non-BZD users than in the noninsomnia group (53.6 mg/dL; 95% CI, 42.9–64.3 vs 40.5 mg/dL; 95% CI, 39.5–41.5). MODD was also significantly higher in non-BZD users compared with the noninsomnia group (50.1 mg/dL; 95% CI, 38.0–62.1 vs 35.6 mg/dL; 95% CI, 34.5–36.7). In contrast, overall CV did not differ significantly between non-BZD users and the noninsomnia group.

When glycemic variability was analyzed by time of day, nocturnal CV was significantly higher in non-BZD users than in the noninsomnia group. No significant associations with SD, CV, or MODD were observed for BZD, ORA, or MRA use. These findings indicate that non-BZD use is associated with increased within-day and between-day glycemic variability measured by CGM in patients with T2DM.