Perceived Stress, Sleep Quality, and Their Impact on Glycemic Control among Type 2 Diabetes Patients in Riyadh: Cross-Sectional Evidence.

Abstract

Objective: The aim of this study was to investigate the relationship between perceived stress and sleep quality with glycemic blood levels in T2DM patients in Riyadh.

Subject and methods: This cross-sectional study evaluated a total of 309 patients diagnosed with type 2 diabetes mellitus in Riyadh, Saudi Arabia. The study comprised an initial validation and Arabic translation phase involving 160 participants, followed by an analytical phase focusing on 149 adult patients. To investigate the impact of psychosocial and metabolic factors on glycemic control (hemoglobin A1c [HbA1c]), data were collected using the Pittsburgh Sleep Quality Index (PSQI) and the Perceived Stress Scale (PSS-10), alongside clinical metrics such as body mass index (BMI) and dyslipidemia extracted from medical records. A multivariable linear regression model was utilized to identify independent factors associated with glycemic regulation within the local population.

Results: The multivariable regression model demonstrated robust explanatory power (adjusted R2 = 0.726, p < 0.001). Traditional risk factors, specifically elevated BMI (β = 0.448, p < 0.001) and dyslipidemia (β = 0.304, p < 0.001), were significantly associated with higher HbA1c levels. Notably, poor sleep quality emerged as a significant independent factor associated with elevated HbA1c (β = 0.261, p < 0.001), whereas perceived stress did not exhibit a significant correlation. Conversely, physical activity demonstrated a significant protective effect, correlating with lower HbA1c (β = -0.271, p < 0.001).

Conclusion: Poor sleep quality, rather than perceived psychological stress, is a primary factor independently associated with hyperglycemia in this patient cohort. These findings suggest that standard diabetes care should integrate formal sleep assessments alongside patient care management.