Association between sleep quality and glycemic control among patients with type 2 diabetes mellitus: a cross-sectional study in a Thai primary care setting

Background: Sleep is a vital homeostatic process linked to circadian rhythms. Sleep deprivation or misalignment can impair insulin sensitivity; however, while studies in urban Thai settings exist, data in primary care remains limited and inconclusive. This cross-sectional study investigated the association between sleep quality and glycemic control among patients with type 2 diabetes mellitus (T2DM) at a primary care unit in Phra Nakhon Si Ayutthaya Hospital. Methods: A total of 109 patients with T2DM were enrolled. Sleep quality was assessed using the Thai version of the Pittsburgh sleep quality index (PSQI). Data were analyzed using descriptive statistics and multiple logistic regression to identify independent predictors of glycemic and blood pressure control. Results: Multiple logistic regression revealed no significant association between sleep quality and glycemic control (Adjusted OR=0.77; 95% CI: 0.35-1.71; p=0.523) or blood pressure control. However, insulin therapy was significantly associated with poor glycemic control (Adjusted OR=7.31; 95% CI: 1.33-40.15; p=0.022). Regarding blood pressure, female gender was a protective factor (Adjusted OR=0.19; p=0.003), while elevated body mass index (BMI) (Adjusted OR=3.76; p=0.034) and insulin use (Adjusted OR=4.72; p=0.049) were significant risk factors. Conclusions: Sleep quality was not associated with glycemic or blood pressure control in T2DM patients in this primary care setting. Clinical management should prioritize other significant determinants, including gender, BMI, and insulin therapy, to optimize patient outcomes.