Korea University Ansan Hospital research team suggested a new paradigm for diabetes management

A research team led by Dr. Lee Da young, Dr. Nan Hee Kim of the Division of Endocrinology and Metabolism (Department of Internal Medicine, Ansan Hospital), Dr. Lee Heon-jeong of the Department of Psychiatry (Anam Hospital), and Dr. Lee Jung-been of the Division of Computer Science and Engineering (Sun Moon University) announced research results indicating that circadian rhythms (biorhythms) are closely related to blood glucose control in patients with type 2 diabetes.

This research is especially at the center of attention as it empirically analyzes the relationship between circadian rhythms and blood glucose changes using CGM and wearable activity monitors.

The research team conducted a study on 122 patients with type 2 diabetes who received insulin treatments at Ansan Hospital from 2021 to 2024. The participants wore CGM and wearable activity monitors for 10 days, and their circadian rhythm-related data were collected, including blood glucose changes, sleep times, physical activity levels, and heart rates.

The data analysis showed that the achievement rate of the blood glucose management goal for the patient group with the highest circadian rhythm stability was 46.3%, which was approximately 2.3 times greater than that of the patient group with the lowest stability (20.0%). In particular, even with analyses that accounted for different major factors such as age, BMI, and HbA1c, the higher the circadian rhythm stability, the higher the probability of achieving blood glucose management goals.

Also, the correlation between activity and blood glucose management showed differences depending on the time of day. The research team divided the day into early morning (00:00-06:00), morning (06:00-12:00), afternoon (12:00-18:00), and night (18:00-24:00) to analyze the relationship between the number of steps and blood glucose indicators by time. The results showed the most distinct correlation between afternoon activities and blood glucose management indicators. Patients with more activity in the afternoon tended to maintain a longer time within the target blood glucose range and exhibited lower blood glucose variability.

Sleep also proved to be closely related to blood glucose management. With sufficient sleep time, patients have a lower risk of experiencing hypoglycemia and smaller fluctuations in blood glucose.

Dr. Lee Da young said, "The conventional management methods of diabetes focused on diet, exercise, and medication. But this research showed that we also need to pay attention to the management of biorhythms. Maintaining regular and stable lifestyle rhythms can help manage your blood glucose levels."

"Now that we have confirmed the correlation between biorhythms and blood glucose management, we will proceed to conduct a follow-up study to verify whether active intervention in patients' lifestyles for adjusting their biorhythms would improve their actual blood glucose levels," she added. "Furthermore, we plan to validate the relationship between biorhythms and various diabetes complications such as diabetic kidney disease and retinopathy."

This study was published in Metabolism, an international academic journal in the field of metabolic diseases and endocrinology. It was also introduced in "People Who Shined Korea (Hanbitsa)," organized by the Biological Research Information Center (BRIC). Hanbitsa is a platform that selects and introduces excellent Korean research published in various international academic journals (Impact Factor of 10 or higher or within the top 3% in each field)