Did you know that too little sleep may increase your risk of developing type 2 diabetes?

To understand the relationship between sleep and blood sugar, WellTuned spoke with Dr. Lisa Staton, a medical director at BlueCross BlueShield of Tennessee.

“Sleep is important for keeping blood sugar at healthy levels,” Dr. Staton says. “Getting too little sleep or poor-quality sleep, or going to bed very late, can make it harder for the body to properly use insulin which is a hormone that turns food into energy and manages blood sugar levels.”

How sleep affects blood sugar regulation

Dr. Staton: The connection between sleep and blood sugar regulation is nothing new. But recent research suggests that people with short sleep or late bedtimes have greater blood sugar fluctuations. Both how long you sleep and when you sleep matter, because they affect the body in different ways.

When you don’t get enough sleep, your body becomes less sensitive to insulin. This means sugar stays in the blood instead of moving into your cells, causing blood sugar levels to rise. Lack of sleep also increases stress hormones like cortisol and hunger hormones like ghrelin. This may raise blood sugar and may lead to weight gain.

When you go to bed very late or have an irregular sleep schedule, your body’s internal clock that tells you when to sleep and wake gets out of sync. This clock, called your circadian rhythm, helps control when hormones are released and when your body is best at handling sugar. If the clock is disrupted, blood sugar may become harder to control, even if you get enough total sleep.

The combination of too little sleep and late bedtime has been associated with the most ups and downs in blood sugar levels.

Poor sleep raises the risk of type 2 diabetes, but the relationship goes both ways. Diabetes can also make sleep worse.

Why this matters to Tennesseans

Dr. Staton: About 13-14% of adults in Tennessee have been diagnosed with diabetes. That is higher than the national average. Tens of thousands of Tennesseans are diagnosed each year. Tennesseans also have higher than average rates of insufficient sleep. The good news is that sleep is a modifiable risk factor, meaning we can influence it. Improving sleep habits represents a practical, low-cost opportunity to help prevent diabetes.

The other good news is that insulin sensitivity can improve within days when sleep is restored. When chronic sleep disorders like obstructive sleep apnea are treated, meaningful glucose changes typically require several weeks, though results vary by individual.

What you can do to improve your sleep

Dr. Staton: Many people can improve sleep with simple, everyday habits:

• Turn off phones, TVs and other screens before bedtime
• Keep your bedroom quiet, dark and comfortable
• Avoid large meals, caffeine or alcohol close to bedtime
• Stay physically active during the day and avoid long daytime naps
• Manage stress through relaxation techniques like deep breathing
• Keep a sleep diary to notice patterns and identify habits that affect sleep quality

Sleep critical to diabetes management

Dr. Staton: The American Diabetes Association now places sleep “on a level playing field” with diet and physical activity in diabetes care. Three key areas matter:

Sleep duration: Sleeping around 7 hours and 18 minutes per night was associated with the best insulin sensitivity. Both shorter and longer sleep can result in worse glucose metabolism.

Sleep quality: Sleep disorders are linked to higher A1C and insulin resistance. It also increases cardiovascular risk.

Sleep timing: Irregular sleep schedules, late bedtimes and changing your body’s natural 24-hour clock affects your health and can make it harder to manage glucose levels.

“Sleep plays a significant role in many aspects of our health,” Dr. Staton says. “Getting adequate and restful sleep should be a top health priority for everyone.”

More from Dr. Staton on WellTuned

Get more information about specific health terms, topics and conditions to better manage your health on bcbst.com. BlueCross BlueShield of Tennessee members can access wellness-related discounts on fitness products, gym memberships, healthy eating and more through Blue365®. BCBST members can also find tools and resources to help improve health and well-being by logging into BlueAccess and going to the Managing Your Health tab.