{
  "abstract": "Background\n\nThis study aimed to explore the association between uncertainty stress and insomnia symptoms and further examine the mediating mediating association of verify the mediating role of healthy lifestyles among Chinese patients with type 2 diabetes.Methods\n\nA multicenter cross-sectional study was conducted based on 3361 patients with type 2 diabetes recruited from 26 community health service centers across China from November 2023 to March 2024. Pearson's correlation test was applied to explore the relationships among the key variables. Regression models were used to examine the mediating associations of healthy Lifestyles. Moreover, Sobel's test and the bootstrap method were employed to confirm the path effects in the models, ensuring the reliability and validity of the results.Results\n\nOut of 3361 diabetes patients, participants had a mean age of 62.16 years, and 51.35% were male. 30.08% experienced insomnia. There was a significant correlation between uncertainty stress, healthy lifestyles, and Insomnia Symptoms (p < 0.01). Uncertainty stress was positively associated with Insomnia Symptoms (β = 0.49, p < 0.01) and negatively associated with on healthy lifestyles (β = - 0.02, p < 0.01). Healthy Lifestyles were negatively associated with insomnia symptoms (β = -0.62, p < 0.001). A small exploratory indirect association of uncertainty stress with insomnia symptoms through healthy lifestyles was observed (β = 0.015, p < 0.001). The Sobel and bootstrap tests confirmed the robustness of the regression analyses.Conclusions\n\nUncertainty stress was positively associated with insomnia symptoms in patients with type 2 diabetes, and healthy lifestyles may partially mediate this association. These findings suggest that reducing uncertainty stress and promoting healthy lifestyle behaviors may be promising targets for future interventions to improve sleep health among community-dwelling adults with type 2 diabetes.",
  "abstract_shown": true,
  "affiliations": [
    "Department of General Practice, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.",
    "Department of General Practice, Changan Town Community Health Service Center, Dongguan, Guangdong, People's Republic of China.",
    "Department of General Practice, Suzhou Hospital affiliated to Anhui Medical University (Suzhou Municipal Hospital of Anhui), Suzhou, Anhui, People's Republic of China.",
    "Department of General Medicine, Qinghai Red Cross Hospital, Xining, Qinghai, People's Republic of China.",
    "Department of General Practice, Wenhui Road Community Health Service Center, Xining, Qinghai, People's Republic of China.",
    "Department of General Medicine, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.",
    "Department of General Practice, The Third People's Hospital of Yunnan Province, Kunming, Yunnan, People's Republic of China.",
    "Department of General Practice, Changan Road Community Health Service Center, Luoyang, Henan, People's Republic of China.",
    "Department of General Practice, The First People's Hospital of Chun'an County, Hangzhou, Zhejiang, People's Republic of China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 12,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "LuSha Li"
    },
    {
      "affs": [
        0
      ],
      "name": "Xixuan Cai"
    },
    {
      "affs": [
        0
      ],
      "name": "Jianjiang Pan"
    },
    {
      "affs": [
        1
      ],
      "name": "Linping Zhang"
    },
    {
      "affs": [
        2
      ],
      "name": "Weiqiang Wang"
    },
    {
      "affs": [
        3
      ],
      "name": "Xingcui Xue"
    },
    {
      "affs": [
        4
      ],
      "name": "Yinghua Xu"
    },
    {
      "affs": [
        5
      ],
      "name": "Abulaite Aizezi"
    },
    {
      "affs": [
        6
      ],
      "name": "Linyan Zhang"
    },
    {
      "affs": [
        7
      ],
      "name": "Qinying Ma"
    },
    {
      "affs": [
        8
      ],
      "name": "Ailian Ye"
    },
    {
      "affs": [
        0
      ],
      "name": "Liying Chen",
      "orcid": "0000-0002-8895-3775"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9s0fxfmz39mjb.bib",
  "cited_by": 0,
  "doi": "10.2147/dmso.s630672",
  "fulltext_url": "https://europepmc.org/articles/PMC13712148",
  "id": "9s0fxfmz39mjb",
  "issns": [
    "1178-7007"
  ],
  "landing_url": "https://europepmc.org/article/MED/42948695",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "3205|Sleep and related disorders"
    ]
  ],
  "openalex": "W7223222892",
  "pdf_url": "https://europepmc.org/articles/PMC13712148?pdf=render",
  "pmcid": "PMC13712148",
  "pmid": "42948695",
  "published": "2026-10-23",
  "publisher": "Dove Press",
  "ris": "https://research.draconitic.com/paper/9s0fxfmz39mjb.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:34Z",
      "native_id": "MED:42948695",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42948695"
    },
    {
      "first_seen": "2026-10-31T12:22:47Z",
      "native_id": "PMC13712148",
      "source": "pmc",
      "url": "https://doi.org/10.2147/dmso.s630672"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:2712|Diabetes, Cardiovascular Risks, and Lipoproteins",
      "subfield": "endocrinology-metabolism"
    }
  ],
  "title": "Association Between Uncertainty Stress and Insomnia Symptoms Among Chinese Patients with Type 2 Diabetes: The Mediating Role of Healthy Lifestyles Based on a Multicenter Cross-Sectional Survey.",
  "title_text": "Association Between Uncertainty Stress and Insomnia Symptoms Among Chinese Patients with Type 2 Diabetes: The Mediating Role of Healthy Lifestyles Based on a Multicenter Cross-Sectional Survey.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:22:47Z",
  "url": "https://research.draconitic.com/paper/9s0fxfmz39mjb",
  "venue": "Diabetes, metabolic syndrome and obesity : targets and therapy",
  "versions": []
}