Dear Editor,
We thank you for the opportunity to respond to the kind and interesting letter from Dr. Monica Andersen, Universidade Federal de Sao Paulo, Brazil, regarding our recent publication in your journal.
We completely acknowledge that it is important to consider sleep quality and sleep disorders when evaluating life quality, especially in people with diabetes. We are also aware that the complex mechanisms of sleep are influenced by many factors, for example pain, and so it is possible that sleep disturbances may be one of the mechanisms behind our finding of reduced quality of life in patients with rheumatological manifestations.
However, we did not investigate the mechanisms behind this reduced quality of life in our study, and we did not include questions regarding sleep quality in our already comprehensive questionnaire. Nevertheless, we do believe the topic to be highly relevant, and we will consider including an evaluation of sleep disturbances in future studies of life quality in type 1 diabetic patients in order to uncover the mechanisms behind this reduced quality of life. Such knowledge could then be used to improve the quality of life of type 1 diabetic patients.
Sincerely yours,
Kirsten Nørgaard and Urd Kielgast