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J Clin Transl Endocrinol. 2019 Jan 2;15:62-64. doi: 10.1016/j.jcte.2018.12.007. eCollection 2019 Mar.

Relationship between depression, sleep quality, and hypoglycemia among persons with type 2 diabetes.

Author information

Division of Academic Internal Medicine and Geriatrics, University of Illinois at Chicago, United States.
Department of Pharmacy Systems, Outcomes, & Policy, University of Illinois at Chicago, United States.
Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand.
Department of Behavioral Sciences, Rush University Medical Center, United States.
Division of Endocrinology and Metabolism, University of Illinois at Chicago, United States.



We analyzed two cohorts of people with type 2 diabetes to evaluate the relationships between depression, sleep quality, and history of hypoglycemia.

Research design and methods:

Two adult cohorts from Chicago (n = 193) and Bangkok, Thailand (n = 282) with type 2 diabetes completed questionnaires to assess sleep quality, depressive symptoms, and hypoglycemia frequency. Proportional odds logistic regression models for each cohort adjusted for duration of therapy, insulin and sulfonylurea management, and other factors.


Those with hypoglycemia in both cohorts had a longer duration of diabetes, greater use of insulin, and worse sleep quality. The Chicago cohort used less sulfonylureas but had higher depressive symptom scores. The Thailand cohort had greater sulfonylurea use. In the final Thailand regression model, depressive symptoms were independently associated with hypoglycemia frequency. In both final Chicago and Thailand models, sleep quality was not associated with hypoglycemia frequency.


In the Thailand cohort, depressive symptoms were associated with hypoglycemia frequency.


Depression; Diabetes mellitus; Hypoglycemia; Sleep; Type 2

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