Melatonin Concentrations and Sleep Quality in Patients with Type 2 Diabetes and Obesity

Open access


There is a close relationship between melatonin as a circadian regulator and insulin, glucagon and somatostatin production. This study aimed to describe subgroups of type 2 diabetes mellitus (T2DM) patients that may benefit from melatonin clock-targeting properties. The study involved 38 participants: 26 T2DM patients, and 12 participants without diabetes in the control group. Subjects were asked to complete the questionnaire of Pittsburgh Sleep Quality Index (PSQI). Standard biochemical venous sample testing was performed, and a sample of saliva was collected for melatonin testing. Melatonin concentration in participants without obesity (body mass index (BMI) < 30 kg/m2) was significantly higher than in obese participants: 13.2 (6.4; 23.50) pg/ml vs 5.9 (0.78; 13.1) pg/ml, p = 0.035. Subjects with BMI 30 kg/m2 had a significantly higher PSQI score than non-obese subjects: 7 (4.5; 10) vs 5.5 (3; 7), p = 0.043. T2DM patients showed significantly lower levels of melatonin than the control group: 6.1 (0.78; 12.2) pg/ml vs 17.8 (8.2; 25.5) pg/ml, p = 0.003. T2DM patients using short-acting insulin analogues showed a significantly higher PSQI score than patients not using insulin: 9 (6; 10) vs 6 (3; 8), respectively (p = 0.025). Poor sleep quality was more prevalent in patients with diabetic retinopathy than in those without this complication (p = 0.031). Lower melatonin levels were detected in T2DM and obese patients. Furthermore, poor sleep quality was observed in T2DM patients using short-acting insulin analogues and those with diabetic retinopathy, and obese individuals.

Akinnusi, M. E., Saliba, R., Porhomayon, J., El-Solh, A. A. (2012). Sleep disorders in morbid obesity. Euro. J. Int. Med., 23 (3), 219–226.

Bach, A. G., Wolgast, S., Muhlbauer, E., Peschke, E. (2005). Melatonin stimulates inositol-1,4,5-trisphosphate and Ca2+ release from INS1 insulinoma cells. J. Pineal Res., 39 (3), 316–323.

Boden, G., Ruiz, J., Urbain, J. L., Chen, X. (1996). Evidence for a circadian rhythm of insulin secretion. Amer. J. Physiol., 271 (2), 246–252.

Bonnefont-Rousselot, D., Collin, F., Jore, D., Gardès-Albert, M. (2011). Reaction mechanism of melatonin oxidation by reactive oxygen species in vitro. J. Pineal Res., 50 (3), 328–335.

Buysse, D. J., Reynolds, C. F. 3rd, Monk, T. H., Berman, S. R., Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psych. Res., 28 (2), 193–213.

Chasens, E. R., Korytkowski, M., Sereika, S. M., Burke, L. E. (2013). Effect of poor sleep quality and excessive daytime sleepiness on factors associated with diabetes self-management. The Diabetes Educator, 39 (1), 74–82.

Chen, W., Cao, H., Lu, Q. Y., Wang, N., Zhao, S. Z., Xu, X., Zheng, Z. (2014). Urinary 6-sulfatoxymelatonin level in diabetic retinopathy patients with type 2 diabetes. Int. J. Clin. Exper. Pathol., 7 (7), 4317–4322.

Costes, S., Boss, M., Thomas, A. P., Matveyenko, A. V. (2015). Activation of melatonin signaling promotes β-cell survival and function. Mol. Endocrinol., 29 (5), 682–692.

Forrestel, A. C., Miedlich, S. U., Yurcheshen, M., Wittlin, S. D., Sellix, M. T. (2017). Chronomedicine and type 2 diabetes: Shining some light on melatonin. Diabetologia, 60 (5), 808–822.

Frese, T., Bach, A. G., Mühlbauer, E., Pönicke, K., Brömme, H. J., Welp, A., Peschke, E. (2009). Pineal melatonin synthesis is decreased in type 2 diabetic Goto–Kakizaki rats. Life Sciences, 85 (13–14), 526–533.

Hikichi, T., Tateda, N., Miura, T. (2011). Alteration of melatonin secretion in patients with type 2 diabetes and proliferative diabetic retinopathy. Clin. Ophthalmol., 5, 655–660.

Ip, M. S., Lam, B., Ng, M. M., Lam, W. K., Tsang, K. W., Lam, K. S. (2002). Obstructive sleep apnea is independently associated with insulin resistance. (2002). Amer. J. Respir. Crit. Care Med., 165 (5), 670–676.

Jin, Q. H., Chen, H. H., Yu, H. L., Li, T. L. (2012). The relationship between sleep quality and glucose level, diabetic complications in elderly type 2 diabetes mellitus. Zhonghua Nei Ke Za Zhi, 51 (5), 357–361.

la Fleur, S. E., Kalsbeek, A., Wortel, J., Fekkes, M. L., Buijs, R. M. (2001). A daily rhythm in glucose tolerance: A role for the suprachiasmatic nucleus. Diabetes, 50 (6), 1237–1243.

Morris, C. J., Yang, J. N., Garcia, J. I., Myers, S., Bozzi, I., Wang, W., Buxton, O., M., A. Shea, S., A., Scheer, F., A., J., L. (2015). Endogenous circadian system and circadian misalignment impact glucose tolerance via separate mechanisms in humans. Proc. Nat. Acad. Sci., 112 (17), 2225–2234.

Mulder, H. (2017). Melatonin signaling and type 2 diabetes risk: Too little, too much or just right? Diabetologia, 60, 826–829.

Mühlbauer, E., Peschke, E. (2007). Evidence for the expression of both the MT1- and in addition, the MT2-melatonin receptor, in the rat pancreas, islet and beta-cell. J. Pineal Res., 42 (1), 105–106.

Park, J. H., Shim, H. M., Na, A. Y., Bae, K. C., Bae, J. H., Im, S. S., Cho, H. C., Song, D. K. (2014). Melatonin prevents pancreatic β-cell loss due to glucotoxicity: The relationship between oxidative stress and endoplasmic reticulum stress. J. Pineal Res., 56 (2), 143–153.

Peschke, E., Frese, T., Chankiewitz, E., Peschke, D., Preiss, U., Schneyer, U., Spessert, R., Mühlbauer, E. (2006). Diabetic Goto Kakizaki rats as well as type 2 diabetic patients show a decreased diurnal serum melatonin level and an increased pancreatic melatonin-receptor status. J. Pineal Res., 40 (2), 135–143.

Peschke, E., Mühlbauer, E., Musshoff, U., Csernus, V. J., Chankiewitz, E., Peschke, D. (2002). Receptor (MT(1)) mediated influence of melatonin on cAMP concentration and insulin secretion of rat insulinoma cells INS-1. J. Pineal Res., 33 (2), 63–71.

Peschke, E., Wolgast, S., Bazwinsky, I., Ponicke, K., Muhlbauer, E. (2008). Increased melatonin synthesis in pineal glands of rats in streptozotocin induced type 1 diabetes. J. Pineal Res., 45 (4), 439–448.

Ramracheya, R. D., Muller, D. S., Squires, P. E., Brereton, H., Sugden, D., Huang, G. C., Amiel, S. A., Jones, P. M., Persaud, S. J. (2008). Function and expression of melatonin receptors on human pancreatic islets. J. Pineal Res., 44 (3), 273–279.

Skomro, R. P., Ludwig, S., Salamon, E., Kryger, M. H. (2001). Sleep complaints and restless legs syndrome in adult type 2 diabetics. Sleep Med., 2, 417–422.

Stumpf, I., Bazwinsky, I., Peschke, E. (2009). Modulation of the cGMP signaling pathway by melatonin in pancreatic beta-cells. J. Pineal Res., 46 (2), 140–147.

Tutuncu, N. B., Batur, M. K., Yildirir, A., Tutuncu, T., Deger, A., Koray, Z., Erbas, B., Kabakci, G., Aksoyek, S., Erbas, T. (2005). Melatonin levels decrease in type 2 diabetic patients with cardiac autonomic neuropathy. J. Pineal Res., 39 (1), 43–49.

Journal Information

CiteScore 2017: 0.22

SCImago Journal Rank (SJR) 2017: 0.127
Source Normalized Impact per Paper (SNIP) 2017: 0.211


All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 73 73 46
PDF Downloads 65 65 48