Relationship Between Sleep Quality and Glycemic Control Among Patients With Type 2 Diabetes

The quality of sleep has been identified as a significant contributor to the management of type 2 diabetes mellitus (T2DM), particularly in achieving optimal blood glucose levels. Although previous research globally has acknowledged this relationship, there is a lack of adequate studies in low- and middle-income countries, such as Pakistan. The purpose of this study is to investigate the relationship between self-management behavior (as indicated by glycemic control) and sleep quality among individuals with type 2 diabetes mellitus (T2DM).

This study is a cross-sectional study conducted from January to May 2025 in outpatient healthcare centers in Islamabad, Pakistan, using a convenience sampling methodology. The study included 385 adult respondents with a diagnosis of type 2 diabetes mellitus (T2DM). The structured questionnaire included sections on demographic characteristics, the Pittsburgh Sleep Quality Index (PSQI), and the Diabetes Self-Management Questionnaire (DSMQ). Data analysis was conducted using IBM Corp. Released 2020. IBM SPSS Statistics for Windows, Version 26. Armonk, NY: IBM Corp., employing descriptive statistics, Spearman correlation, Mann-Whitney U tests, Kruskal-Wallis H tests, chi-square tests, and linear regression to investigate the relationship between sleep quality and diabetic self-management practices.

A total of 385 participants took part in the study, comprising 195 males (51%) and 190 females (49%). PSQI and DSMQ were also negatively correlated at a highly significant level (r = -0.119, p = 0.020), and this indicates that poor quality of sleep was interrelated with a low rate of self-management of diabetes. Female respondents also had significantly lower scores in sleep quality and reached higher scores in self-management than male respondents (p < 0.01). There were also significant differences in the PSQI and DSMQ scores, even when marital status was taken into account (p < 0.01). Based on the results of linear regression, it was possible to note that PSQI scores had a significant effect on predicting DSMQ scores (B = -0.452, p = 0.021); thus, the lower the score of the sleep quality measure, the less positive were the diabetes self-care behaviors.

It was found that sleep quality and glycemic control behaviors predict a strong negative interrelationship in T2DM patients in Pakistan. The management of diabetes should consider including a sleep assessment. To achieve improved outcomes, recommended gender- and marital status-sensitive interventions are advised, including a targeted approach to self-management and sleep hygiene.