Disclosures: The Danish Diabetes Academy, the Independent Research Fund Denmark and the Novo Nordisk Foundation supported this study. The authors report no relevant financial disclosures.
August 26, 2021
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Melatonin safe sleep aid for adults with metabolic diseases

Disclosures: The Danish Diabetes Academy, the Independent Research Fund Denmark and the Novo Nordisk Foundation supported this study. The authors report no relevant financial disclosures.
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Melatonin may be a safe sleep aid for people with metabolic diseases and for healthy adults, and data suggest a beneficial glucose effect, according to findings published in Clinical Endocrinology.

“Melatonin treatment does not significantly affect fasting plasma glucose levels in a pooled analysis of 603 healthy adults and patients with glucose-metabolic diseases,” Esben Stistrup Lauritzen, MD, a doctoral student at the Steno Diabetes Center and Aarhus University Hospital, Denmark, and colleagues wrote. “Likewise, a subgroup analysis with healthy participants in one group and patients with glucose-metabolic diseases in another group revealed that melatonin treatment did not affect fasting glucose levels in either group. Interestingly, fasting insulin levels were significantly reduced in the 278 individuals included, although the effect was small. Furthermore, the insulin sensitivity and BMI trended to improve with melatonin treatment.”

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In a systematic review and meta-analysis, Lauritzen and colleagues assessed the effect of at least 2 weeks of daily treatment with melatonin on fasting glucose, insulin, insulin sensitivity and HbA1c levels across 11 randomized, placebo-controlled studies (n = 603). Researchers calculated Hedges’ g differences for the metabolic parameters and random effects models for the meta-analyses.

Compared with placebo, long-term treatment with melatonin did not change fasting glucose (g = –0.07; 95% CI, –0.22 to 0.08), but reduced fasting insulin levels slightly (g = –0.27; 95% CI, –0.5 to –0.04) and trended toward reduced homeostasis model assessment of insulin resistance (HOMA-IR; g = –0.2; 95% CI, –0.44 to 0.03) among 278 adults.

HbA1c levels were largely unaffected by melatonin treatment compared with placebo; however, only two studies assessed HbA1c levels.

“Given the wide confidence intervals, larger studies are warranted to confirm the effect of melatonin treatment on fasting insulin levels and further explore the effect of melatonin on HbA1c levels and insulin sensitivity, but with the current evidence and literature available, immediate-release melatonin seems to be a glucose-metabolic safe sleeping aid,” the researchers wrote. “The improved fasting insulin levels and the trend towards improved insulin sensitivity could have been mediated by a reduction in BMI after melatonin treatment, but a subgroup analysis of BMI in the five studies that measured insulin and HOMA-IR showed a negligible effect of melatonin on BMI, making this suggestion less likely.”