Association Between Hypnotics and Glycemic Variability Assessed by Continuous Glucose Monitoring Under Real-Life Conditions in Patients With Type 2 Diabetes - Cross-Sectional Study

Sep 29, 2026

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Association between hypnotic use and glycemic variability in real-life patients with type 2 diabetes was examined because insomnia is common and may impair glycemic control. A cross-sectional design enrolled individuals who underwent continuous glucose monitoring from June 1, 2017 to February 28, 2022. Participants were grouped by insomnia status and hypnotic exposure, and glycemic variability was quantified using SD, CV, and MODD. Non–benzodiazepines were linked to higher within- and between-day variability, including nocturnal CV differences.

LanguageEnglish

CategoryHealthcare

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Pages9

Reading Time23 min

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Background

Methods

Results

Conclusions

Introduction

Wiley Journal of Diabetes Research Volume 2025, Article ID 1748628, 9 pages [https://doi.org/10.1155/jdr/1748628](https://doi.org/10.1155/jdr/1748628) Research Article Association Between Hypnotics and Glycemic Variability Assessed by Continuous Glucose Monitoring Under Real-Life Conditions in Patients With Type 2 Diabetes: A CrossSectional Study Taichi Muramatsu , 1 Miku Otsuka , 1 Daisuke Yamamuro , 1 Mikan Yamanouchi , 1 Saaya Fujisaka , 1 Akifumi Kushiyama , 1 and Takako Kikuchi 2 1Department of Pharmacotherapy, Meiji Pharmaceutical University, Kiyose, Tokyo, Japan 2Division of Diabetes and Metabolism, The Institute of Medical Science, Asahi Life Foundation, Chuo-ku, Tokyo, Japan Correspondence should be addressed to Akifumi Kushiyama; [kushiyama@my-pharm.ac.jp](kushiyama@my-pharm.ac.jp) Received 21 February 2025; Revised 26 September 2025; Accepted 24 October 2025 Guest Editor: LVKS Bhaskar Copyright © 2025 Taichi Muramatsu et al. Journal of Diabetes Research published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. Background: Insomnia is common in patients with Type 2 diabetes and can negatively aﬀect glycemic control. However, the eﬀect of hypnotic use on glycemic variability remains unclear. Therefore, we investigated the association between hypnotic use and glycemic variability in patients with Type 2 diabetes. Methods: This cross-sectional study enrolled patients with Type 2 diabetes who underwent continuous glucose monitoring (CGM) between June 1, 2017, and February 28, 2022 . Patients were classiﬁed into six groups based on their insomnia status and hypnotic use: noninsomnia, hypnotic nonusers, benzodiazepine (BZD) users, nonbenzodiazepine (non-BZD) users, orexin receptor antagonist (ORA) users, and melatonin receptor agonist (MRA) users. We used the standard deviation (SD) of glucose, the coeﬃcient of variation (CV) of glucose, and the mean of daily diﬀerence (MODD) as indicators of glycemic variability. The independent association between hypnotic use and glycemic variability was assessed using a multiple linear regression model. Results: A total of 534 patients were included in the analysis (mean age: 67 7± 10 1 years old; mean diabetes duration: 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) . The SD was signiﬁcantly higher in non-BZD users (53.6mg/dL, 95% conﬁdence interval [CI]: 42.9–64.3) than in the noninsomnia group (40.5mg/dL, 95% CI: 39.5–41.5) . MODD was also signiﬁcantly higher in non-BZD users (50.1mg/dL, 95% CI: 38.0–62.1) than in the noninsomnia group (35.6mg/dL, 95% CI: 34.5–36.7) . In contrast, the CV was not signiﬁcantly diﬀerent between nonBZD users and the noninsomnia group. When analyzed separately for diﬀerent times of the day, the nocturnal CV was signiﬁcantly higher in non-BZD users than in the noninsomnia group. Conclusions: The use of non-BZDs was associated with within-day and between-day glycemic variability measured by CGM inpatients with Type 2 diabetes. 1. Introduction In recent decades, blood glucose management in patients with Type 2 diabetes has advanced considerably, driven by developments in pharmacotherapy and medical technology. While glycated hemoglobin (HbA1c) remains the gold standard for assessing long-term glycemic control, it does not adequately capture glycemic variability or acute glucose ﬂuc- tuations [1] . A modern approach to glycemic management emphasizes not only achieving optimal HbA1c levels but also reducing glycemic variability as much as possible [2] . Short-term glycemic variability refers to glycemic oscillations, reﬂecting hypoglycemic and postprandial spikes as well as ﬂuctuations that occur simultaneously on diﬀerent days [3] . Continuous glucose monitor

FAQs

What was the study’s main objective?

To determine whether hypnotic use is associated with glycemic variability in patients with type 2 diabetes under real-life conditions assessed by continuous glucose monitoring.

How were participants grouped in this cross-sectional study?

Patients were classified into six groups based on insomnia status and hypnotic use: noninsomnia, hypnotic nonusers, benzodiazepine users, nonbenzodiazepine users, orexin receptor antagonist users, and melatonin receptor agonist users.

Which hypnotic category showed significant associations with glycemic variability?

Non–benzodiazepine users showed significantly higher SD and MODD than the noninsomnia group, and nocturnal CV was also significantly higher.

Sep 29, 2026

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