A new 'global atlas' study published in Diabetologia (the journal of the European Association for the Study of Diabetes [EASD]) is the first to identify insomnia as a risk factor associated with increased risk of developing type 2 diabetes (T2D). The study identifies 34 risk factors that are thought to increase (19) or decrease risk (15), as well as a further 21 'suggestive' risk factors where evidence was not quite as strong.
The study by Associate Professor Susanna Larsson and by Shuai Yuan of the Karolinska Institutet, Stockholm, Sweden, used a technique called 'Mendelian Randomization' (MR), which uses genetic variation as a natural experiment to investigate the causal relations between potentially modifiable risk factors and health outcomes in observational data. MR is less likely to be affected by confounding or reverse causation than observational studies.
To identify possible risk factors for T2D, the authors conducted a review of meta-analyses and review articles in the PubMed database and found 1,360 relevant articles. They found a total of 97 risk factors that could be investigated using the MR method. For the study population, they used summary-level data from the Diabetes Genetics Replication And Meta-analysis consortium (74,124 types 2 diabetes cases and 824,006 controls of European ancestry). The team then checked that these potential causal associations could be replicated in a separate independent population, using the FinnGen consortium (11,006 types 2 diabetes cases and 82,655 controls of European ancestry).
They found evidence of causal associations between 34 exposures (19 risk factors and 15 protective factors) and T2D. Insomnia was identified as a novel risk factor, with people with insomnia being 17% more likely to develop T2D than those without.
The other 18 risk factors for T2D were depression, systolic blood pressure, starting smoking, lifetime smoking, coffee (caffeine) consumption, blood plasma levels of the amino acids isoleucine, valine, and leucine, liver enzyme alanine aminotransferase (a sign of liver function), childhood and adulthood body mass index (BMI), body fat percentage, visceral (internal) fat mass, resting heart rate, and blood plasma levels of four fatty acids.
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