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World J Diabetes. Nov 15, 2016; 7(19): 515-522
Published online Nov 15, 2016. doi: 10.4239/wjd.v7.i19.515
Sleep, circadian dysrhythmia, obesity and diabetes
Gumpeny Ramachandra Sridhar, Narasimhadevara Santhi Nirmala Sanjana
Gumpeny Ramachandra Sridhar, Endocrine and Diabetes Centre, Visakhapatnam 530002, India
Narasimhadevara Santhi Nirmala Sanjana, MGM Medical College, Navi Mumbai 410209, India
Author contributions: Both authors Sridhar GR and Sanjana NSN contributed equally to the writing of the manuscript.
Conflict-of-interest statement: There is no conflict of interest associated with.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Gumpeny Ramachandra Sridhar, MD, DM, FACE, FRCP, Endocrine and Diabetes Centre, 15-12-15 Krishnanagar, Visakhapatnam 530002, India. sridharvizag@gmail.com
Telephone: +91-891-2566301 Fax: +91-891-2509427
Received: April 29, 2016
Peer-review started: May 3, 2016
First decision: June 17, 2016
Revised: August 16, 2016
Accepted: August 27, 2016
Article in press: August 29, 2016
Published online: November 15, 2016
Processing time: 194 Days and 22.1 Hours
Abstract

Synchrony of biological processes with environmental cues developed over millennia to match growth, reproduction and senescence. This entails a complex interplay of genetic, metabolic, chemical, light, hormonal and hedonistic factors across life forms. Sleep is one of the most prominent rhythms where such a match is established. Over the past 100 years or so, it has been possible to disturb the synchrony between sleep-wake cycle and environmental cues. Development of electric lights, shift work and continual accessibility of the internet has disrupted this match. As a result, many non-communicable diseases such as obesity, insulin resistance, type 2 diabetes, coronary artery disease and malignancies have been attributed in part to such disruption. In this presentation a review is made of the origin and evolution of sleep studies, the pathogenic mediators for such asynchrony, clinical evidence and relevance and suggested management options to deal with the disturbances.

Keywords: Insulin resistance; Chronotype; Obesity; Evolution; Clock; Shift work

Core tip: Humans evolved to match external environment with internal metabolism. Day-night cycle is an important rhythm to achieve synchrony. A central clock interacts with peripheral clocks in various parts of the body. Reduced sleep, shift work and inappropriate exposure to light during sleep hours disturb this rhythm leading to abnormalities such as obesity, insulin resistance and type 2 diabetes. Understanding the complex interactions of the various factors involved in this system can help in the prevention and in treatment of such adverse effects.