New-Onset Diabetes Predicted by Sleep-Time Ambulatory Blood Pressure

(HealthDay News) — Sleep-time ambulatory blood pressure (BP) predicts new-onset diabetes, and ingestion of hypertension medications at bedtime is associated with reduced risk for new-onset diabetes, according to two studies published in Diabetologia.

Ramón C. Hermida, PhD, from the University of Vigo in Spain, and colleagues examined the prognostic value of clinic and ambulatory BP to predict new-onset diabetes in a cohort of 2,656 individuals without diabetes. 

The researchers found that during a median follow-up of 5.9 years, 190 participants developed type 2 diabetes. The most significant predictor of new-onset diabetes was sleep-time systolic ambulatory BP in a model adjusted for confounding variables. 

Per one-standard deviation decrease in sleep-time systolic ambulatory BP mean there was a 30% reduction in the risk for new-onset diabetes.

In a second study, Hermida and colleagues examined whether bedtime ingestion of hypertension medications correlated with reduction in the risk of new-onset diabetes. The trial included 2,012 patients with hypertension without diabetes. 

During a 5.9-year median follow-up, the researchers identified 171 patients who developed type 2 diabetes. Patients in the bedtime vs. the morning-treatment group had significantly lower sleep-time BP mean, greater sleep-time relative BP decline, and lower prevalence of non-dipping at the final evaluation. 

After adjustment for confounding variables, they also had a significantly lower hazard ratio for new-onset diabetes (adjusted hazard ratio, 0.43).

“Ingestion of the entire daily dose of ≥1 BP-lowering medications at bedtime compared with ingestion of all such medications upon-awakening, results in significantly improved asleep ambulatory BP control and prevention of new-onset diabetes,” Hermida and colleagues wrote in the second study.

References

1. Hermida RC, Ayala DE, Mojón A, Fernández JR. Sleep-time BP: prognostic marker of type 2 diabetes and therapeutic target for prevention. Diabetologia. 2015;doi:10.1007/s00125-015-3748-8.
2. Hermida RC, Ayala DE, Mojón A, Fernández JR. Bedtime ingestion of hypertension medications reduces the risk of new-onset type 2 diabetes: a randomised controlled trial. Diabetologia. 2015;doi:10.1007/s00125-015-3749-7.