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.
9 affiliations
- 1Department of General Practice, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.
- 2Department of General Practice, Changan Town Community Health Service Center, Dongguan, Guangdong, People's Republic of China.
- 3Department of General Practice, Suzhou Hospital affiliated to Anhui Medical University (Suzhou Municipal Hospital of Anhui), Suzhou, Anhui, People's Republic of China.
- 4Department of General Medicine, Qinghai Red Cross Hospital, Xining, Qinghai, People's Republic of China.
- 5Department of General Practice, Wenhui Road Community Health Service Center, Xining, Qinghai, People's Republic of China.
- 6Department of General Medicine, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.
- 7Department of General Practice, The Third People's Hospital of Yunnan Province, Kunming, Yunnan, People's Republic of China.
- 8Department of General Practice, Changan Road Community Health Service Center, Luoyang, Henan, People's Republic of China.
- 9Department of General Practice, The First People's Hospital of Chun'an County, Hangzhou, Zhejiang, People's Republic of China.
Abstract
Background
This 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
A 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
Out 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
Uncertainty 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.
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BibTeX
@article{li2026association,
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.}},
author = {LuSha Li and Xixuan Cai and Jianjiang Pan and Linping Zhang and Weiqiang Wang and Xingcui Xue and Yinghua Xu and Abulaite Aizezi and Linyan Zhang and Qinying Ma and Ailian Ye and Liying Chen},
journal = {Diabetes, metabolic syndrome and obesity : targets and therapy},
year = {2026},
month = oct,
doi = {10.2147/dmso.s630672},
url = {https://europepmc.org/article/MED/42948695},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - 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.
AU - LuSha Li
AU - Xixuan Cai
AU - Jianjiang Pan
AU - Linping Zhang
AU - Weiqiang Wang
AU - Xingcui Xue
AU - Yinghua Xu
AU - Abulaite Aizezi
AU - Linyan Zhang
AU - Qinying Ma
AU - Ailian Ye
AU - Liying Chen
PY - 2026
DA - 2026/10/23
JO - Diabetes, metabolic syndrome and obesity : targets and therapy
DO - 10.2147/dmso.s630672
UR - https://europepmc.org/article/MED/42948695
AB - Background This 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 A 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 Out 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 Uncertainty 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.
SN - 1178-7007
ER -