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Is Melatonin Safe For Diabetics

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Dont Drink Alcohol Before Bed

Health experts warn of risks with taking melatonin

Alcohol affects blood sugar levels. Alcohol impairs the release of glucose into the bloodstream, and it takes about two hours for your body to completely metabolize any alcohol youve consumed, according to the InDependent Diabetes Trust, an England-based advocacy organization for people living with diabetes. If you drink alcohol, do so in moderation and only with food, the organization says. The 20152020 U.S. Dietary Guidelines for Americans defines moderation as up to one drink per day for women and up to two drinks per day for men. To reduce the risk of sleep disturbances, the NSF recommends stopping alcohol consumption four hours before bedtime. Not to mention, not drinking too much before going to sleep might also help you avoid having to get up to go to the bathroom during the night. Alcohol is a fragmenter of sleep, Strohl says.

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Effects Of Melatonin In Diabetic Cardiomyopathy

Diabetes is causally related to adverse changes in the myocardial structure and function. It has been demonstrated in the last decade or two that apoptosis in cardiomyocytes increases in diabetic patients and STZ-induced diabetic animals owing to the accumulation of ROS . Further, in a nested case-control study, it was found that lower melatonin secretion was significantly associated with a greater risk of myocardial infarction in women with increased BMI . A wealth of data exists

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Ways To Sleep Better When You Have Diabetes

Everyone needs good sleep, but its particularly important when you have type 2 diabetes. Getting inadequate amounts of sleep can negatively impact blood sugar levels, short and long term, says Gregg Faiman, MD, an endocrinologist at University Hospitals Cleveland Medical Center in Ohio. In fact, sleep is as essential to your health as nutrition and exercise, he says.

Too little sleep puts stress on your body, causing it to release hormones, including cortisol. Cortisol increases insulin resistance and increases blood sugar levels, Dr. Faiman says. On the other hand, too much sleep may also pose health dangers for people with type 2 diabetes. In a study published in 2020 in Diabetologia, individuals with diabetes who slept more than seven hours had an elevated risk of dying early, compared with those who got a full seven hours.

The following strategies can help ensure that youre getting optimal rest when managing type 2 diabetes.

Study Shows Melatonin Improves Sleep And A1c Levels

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Type 2 diabetes is a major co-morbidity in many people who have insomnia. In a study, Israeli researchers examined the safety and effectiveness of prolonged-release melatonin in the treatment of glucose, lipid metabolism, and sleep in 36 patients who have type 2 diabetes and insomnia.

A total of 11 men and 25 women participated in this randomized, double-blind, crossover study. Participants were between 46 and 77 years old.

Results of the study appeared in the November 2011 issue of Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy in the article Efficacy and safety of prolonged-release melatonin in insomnia patients with diabetes: a randomized, double-blind, crossover study.

Study participants were given prolonged-release melatonin or a placebo for 3 weeks , followed by a 1-week washout period, and then crossed over for another 3 weeks of treatment with the other preparation . All tablets were taken 2 hours prior to bedtime for 3 weeks.

In an extension period of 5 months, all study participants were given prolonged-release melatonin nightly. This was done in an open-label design. Sleep was monitored objectively in a sub-group that included 22 study participants. Wrist actigraphy was used.

The following levels were measured at baseline and at the end of the study:

  • high-density and low-density lipoprotein cholesterol

Following 5 months of prolonged-release melatonin use, it was noted that mean A1c was significantly lower than at baseline .

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Association Between Polymorphisms Of The Mtnr1b Locus And Diabetes

Melatonin receptor deficiency or malfunction has been related to various diseases. Changes in insulin secretion observed in MT2 variants and melatonin effects on glycogen synthesis mediated through an atypical PKC -Akt-glycogen synthase kinase 3 signaling pathway may be interpreted in this context. Likewise, the finding that the MT1 knockout causes insulin resistance in mice seems to support the general idea of intact melatonin signaling required for avoiding type 2 diabetes, but may also be indicative of species differences between mice and humans. Recently, genome-wide association studies revealed a close link between specific single nucleotide polymorphysms of the melatonin MT2 receptor locus and a prognostic risk of type 2 diabetes. In fact, these studies present evidence that a particular SNP significantly increases the risk of type 2 diabetes in the European cohorts examined. The coding sequence of MTNR1B is interrupted by a single intron and the SNP rs10830963 is localised within the non-coding intron sequence, although it does not interfere with consensus sequences for transcription factors or with splicing. However, this SNP is correlated with higher fasting glucose levels and a high incidence of this allele is also correlated with pathologically altered insulin secretion responses.

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Melatonin: The Diabetes Treatment Of The Future

Taking melatonin comes with risks

Diabetes is one of the worlds leading causes of death, affecting millions of people around the globe. Researchers now say: by reducing oxidative stress, the sleep hormone melatonin might be useful in the management of diabetes symptoms and complications. Is there reason to hope?

Diabetes is a metabolic disorder characterized by high blood sugar due to a build-up of glucose. Insulin helps cells take in glucose however, when the pancreas cannot produce enough insulin or when the body cannot use this insulin properly, glucose becomes trapped in the blood.

Over time, high blood sugar can lead to, or aggravate, additional health problems, such as heart disease and stroke, leading diabetes to become known as the silent killer. Symptoms can be managed using various methods, however, these do come with side effects and there is currently no cure.

In an article, recently published in Hormone Molecular Biology and Clinical Investigation, researchers from Malaysia and New Zealand explain how melatonin may help in the fight against diabetes. Melatonin is a hormone mainly secreted by the pineal gland a small endocrine gland in the brain. Its production is under the control of our circadian rhythm, so is inhibited in the morning and released during the night.

Diabetes and oxidative stress

Moreover, melatonin has other beneficial effects and roles within the body, such as inducing the production of other antioxidants, maintaining homeostasis and regulating the wake-sleep cycle.

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Synthesis And Function Of Melatonin

Melatonin is an integral part of the homeostatic mechanism in the body. It signals whether light or dark prevails. Melatonin, like the neurotransmitter serotonin, is an indoleamine. It is converted in two steps from the amino acid tryptophan into serotonin , and then acetylated by arylalkylamine N-acetyltransferase , the rate-limiting step in melatonin biosynthesis, before finally being converted into melatonin by hydroxyindole-O-methyltransferase .

The indoleamine is mainly secreted by endocrine cells in the pineal gland, which is located in the midline of the brain, just above the posterior commissure at the dorsal edge of the third ventricle. Melatonin remains detectable after pinealectomy in some species, and subsequent investigations have revealed that the hormone is also produced by neurendocrine cells in the retina, Harderian glands, gastrointestinal tract and pancreas. Melatonin is also produced by numerous non-endocrine cells, e.g., immune cells. Hence, while the pineal gland quantitatively accounts for the circulating pool of the hormone, substantial local synthesis also occurs in retinal and peripheral tissues such as the gastrointestinal tract.

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Few Need It But Many Take It

Esben Lauritzen says that the research results are relevant for the debate on taking melatonin as a sleep aid.

Melatonin is approved as a sleep aid for people older than 55 years, for treating jet lag and for children and adolescents with attention-deficit/hyperactivity disorder and other mental disorders. However, the drastic increase in consumption also suggests that other people take melatonin.

The use of melatonin is increasing even though the side-effects have not been mapped, and although the new study does not provide a clear answer, it suggests that melatonins effects extend beyond purely sleep-related ones.

Our bodies produce melatonin at night, but the doses that people take to fall asleep can result in concentrations in the bloodstream that are 100 times greater than the concentration we produce naturally. Perhaps melatonin in the concentrations that we produce ourselves does not have negative effects on glucose homeostasis. However, we cannot rule out that taking hefty quantities of melatonin may affect glucose metabolism and be harmful to health. Conversely, disturbed sleep is also associated with reduced glucose uptake into the tissue because of decreased insulin sensitivity and an increased risk of obesity, type 2 diabetes and cardiovascular disease. This means that elucidating the potential effects of taking melatonin daily, as many people do, is important, concludes Esben Lauritzen.

What Are Reasons For Taking Melatonin

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Melatonin, sold as a supplement, can help with some conditions, including jet lag, delayed sleep-wake phase disorder, sleep disorders in children, and anxiety before and after surgery, for example.

Melatonin production declines with age, so older adults who have difficulty falling or staying asleep may be interested in taking a melatonin supplement.

To get cutting-edge diabetes news, strategies for blood glucose management, nutrition tips, healthy recipes, and more delivered straight to your inbox, !

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Melatonin Is An Appropriate Agent For The Treatment Of Diabetic Nephropathy

Diabetic nephropathy, as one of the main microvascular complications of both type 1 and type 2 diabetes mellitus, is the most frequent cause of end-stage renal diseases. Diabetic nephropathy is characterized by nephron enlargement, glomerular hyperfiltration as well as the hypertrophy of mesangial cells, which eventually develops into glomerulosclerosis . Several mechanisms have been proposed for diabetic nephropathy progression and development, including lipid disorders, oxidative stress, pro-fibrotic and fibrotic cytokines generation -1, plasminogen activator inhibitor -1, and connective tissue growth factor .

As mentioned above, ROS have a key role in diabetic complications . In hyperglycemia state, the persistent oxidative stress contributes to damage to the nuclear DNA and the mitochondrial genetic material .

Hyperglycemia leads to apoptosis in different types of cells in diabetic nephropathy, such as the proximal tubule epithelial cells . It has been previously explained that the apoptosis occurs through activating numerous intracellular signaling pathway . Now, it is acknowledged that hyperglycemia mediates apoptosis and promotes the gradual loss of kidney function in diabetic nephropathy .

Table 5 The application of melatonin for the treatment of diabetic nephropathy

The Therapeutic Effects Of Melatonin On Diabetic Retinopathy

Diabetic retinopathy , a prevalent asymptomatic microvascular complication of diabetes mellitus, is a leading cause of vision loss worldwide . According to recent reports, one-third of diabetic patients possess some degree of diabetic retinopathy . Due to the increasing prevalence of diabetes worldwide, the number of diabetic retinopathy patients has been estimated to elevate from 424.9 million in 2017 to 628 million by 2045 .

Nowadays, as mentioned earlier, inflammation and oxidative stress have crucial roles in diabetic retinopathy pathogenesis . Therefore, treatments such as melatonin restricting inflammatory and oxidative impacts of diabetes mellitus could be greatly potential to affect individuals through preventing or decreasing the retinal complications .

Various and heterogeneous factors, such as advanced glycation end products , growth factors, hyperglycaemia as well as great levels of vitreous or circulating chemokines, cytokines and ROS can trigger the inflammatory responses in the retinal vasculature . Thus, mounting evidence suggests chronic inflammation as an essential process in the development of diabetic retinopathy, primarily in early stages .

Table 2 Effects of melatonin on diabetic retinopathy reported by various investigations

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How Melatonin Affects Blood Sugar: What The Research Shows

Numerous studies have been conducted looking at how melatonin levels affect glucose. To date, no consensus has been reached. Some studies have yielded findings that higher melatonin levels are beneficial to metabolic health while others show it has a harmful effect.

For example, some research suggests that at a cellular level, melatonin is important for the survival and function of beta cells, which are responsible for producing insulin, the hormone that controls the level of glucose in the blood.

Additionally, a study published in JAMA found that low levels of melatonin in the blood were independently associated with an increased risk of insulin resistance and Type 2 diabetes. Another study published in the American Journal of Epidemiology looked at 1,075 generally healthy, non-obese women. The researchers found that higher nighttime melatonin levels were linked to greater insulin sensitivity and a lower prevalence of insulin resistance.

Youll want to avoid eating when melatonin levels are naturally high, like at nighttime. This would mean eating an earlier dinner and avoiding late-night snacking.

In a study published in the journal, Clinical Endocrinology researchers administered either 1 mg of melatonin or a placebo to 22 postmenopausal women first thing in the morning. The participants then underwent glucose tolerance testing 45 minutes later. The researchers found that those who received the melatonin had reduced glucose tolerance and insulin sensitivity.

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