Sleep and diabetes risk: why sleep matters more than you think

Sleep isn’t a luxury; it’s an essential part of staying healthy, alongside exercise and nutrition.

Not getting enough sleep can significantly increase the risk of type 2 and gestational diabetes^1,2 and make it harder to manage type 1 diabetes.

Sleeping less than 6 to 7 hours per night has been shown to increase the risk of obesity, type 2 diabetes and heart disease³.

Lack of sleep can result in:

Reduced insulin sensitivity⁴: Insulin is a hormone made by your pancreas that regulates glucose levels in your body. Insulin resistance means the cells in your body don’t respond as they should to insulin, you have low insulin sensitivity. This forces the pancreas to overproduce insulin to compensate. As insulin resistance progresses the pancreas can fail to produce enough insulin, leading to type 2 diabetes.

Reduced glucose tolerance: This is a metabolic condition in which your body struggles to process sugar effectively, leading to higher-than-normal blood sugar levels.

Increased stress hormones: Stress triggers the release of stress hormones, such as cortisol and adrenaline, which can lead to an increase in blood glucose levels. When the body loses its ability to regulate blood glucose effectively, it can, over time, lead to the development of type 2 diabetes.

Changes in appetite and food choices: Lack of sleep can affect the appetite-regulating hormones, ghrelin and leptin.⁵ This can result in craving foods high in fat and refined carbohydrates. It’s estimated that a lack of sleep can increase our energy intake by around 20%.⁶ This can lead to obesity, which increases the risk of type 2 diabetes.

Lack of exercise: The more tired you are, the harder it can be to feel motivated to do any exercise.

Combined, these factors can contribute to type 2 diabetes and make it harder to manage existing diabetes.

For people with existing diabetes, lack of sleep can cause:

• Blood sugar fluctuations: Poor sleep may contribute to higher fasting blood glucose levels and greater difficulty maintaining target glucose ranges.
• Impact on daily diabetes management: Fatigue can affect food choices, physical activity, and the ability to remember to take any medication.

People with diabetes often report that it affects their sleep, and may experience symptoms including:

Sleep apnoea: Mild sleep apnoea can be reduced by sleeping on your side or using a special pillow. Maintaining a healthy weight and reducing alcohol consumption can also help.

Restless leg syndrome: A warm bath or massage may help reduce these symptoms. Avoiding caffeine and alcohol may also improve symptoms.

Nerve pain: Gentle exercise may help ease it. Vitamin B12 may relieve neuropathic pain, tingling, and numbness.⁷

Good sleep habits, often called good sleep hygiene, can help ensure you get a good night’s sleep.

Keep your bedroom cool, dark and quiet.

Turn off all electronic devices, including televisions, phones and computers at least an hour before bedtime. People who use screens before bed report 33% poorer sleep quality than those who limit screen time in the lead-up to bedtime.⁸

Avoid stimulants such as alcohol and caffeine before bed.

Be consistent. Wake up and go to bed at the same time every night.

Get regular exercise. People who have at least 10 minutes a day of vigorous exercise tend to have more restorative sleep than those who exercise less regularly but for longer.⁹ But it’s best to avoid exercise in the hour before bed.¹⁰

Manage stress. Meditation and mindfulness can help you fall asleep.

Sleep plays a powerful role in how your body regulates blood glucose, appetite and energy.

Building consistent, healthy sleep habits can support better metabolic health (how your body processes and uses energy) and may help reduce the risk of type 2 diabetes, while also making day-to-day diabetes management easier and more stable.

Diabetes Australia provides resources and information on diabetes prevention and management.

The Sleep Health Foundation offers resources on sleep and tips for good sleep hygiene.