General information and clinical parameters

A total of 182 participants were enrolled into this study. The 81 diabetic patients were distributed into comorbidity group according to the diagnosis of anxiety and depression, the rest of the 101 T2DM were into control group. There were no significant differences in age, BMI, waistline, family history and the ratio of other chronic disease between the two groups. The basic information of the study population and analysis results were shown in Table 1. The results showed that the proportion of female in comorbidity group was significantly higher than the ratio of control group (p = 0.002). The clinical characteristics of all the participants were shown in Table 2. Compared with control group, the biochemical markers including thyroid function parameters and indicators of liver and kidney function were balanced and had no statistical differences. However, SDBG and PPGE in comorbidity group were higher than those in control group, and the differences were statistically significant (p = 0.032 and p = 0.037).

Table 1 General information of the study population Full size table

Table 2 Clinical characteristics of the two groups Full size table

Comparison of sleep status and life behavior

In the comorbidity group, people who had the habit of napping account for 66.67%, which was higher than 55.45% in control group, but the difference was not statistically significant (p = 0.124). Significant differences of sleep quality and PSQI were existed in the two groups (p < 0.001 and p < 0.001, Fig. 1). The results of behavioral questionnaires survey (Table 3) showed the habits including alcohol, tea, and smoking habit of the two group had no statistically significant difference (p = 0.083, p = 0.65 and p = 0.095). The difference of dietary structure between comorbidity and control groups was statistically significant (p < 0.001).

Fig. 1 Contrastive analysis of Pittsburgh sleep quality index and sleep quality Full size image

Table 3 The comparison of sleep quality and behavioral style Full size table

Stratification analysis

In this study, there were statistical differences in the gender ratio between the two groups. So the status of anxiety, depression and cognitive disorder in both male and female group were analyzed in this study. The analysis results showed that ratios of cognitive disorder, anxiety and depression in female patients were all significantly higher than that in male diabetes patients (p = 0.001, p < 0.001 and p < 0.001). The differences of MMSE score, SAS score and PHQ9 score were also statistically significant between female T2DM group and male patient group (p = 0.001, p < 0.001 and p < 0.001). The specific analysis results were shown in Table 4. In this research, there was a significant association between gender and depression, thus it was a confounding factor needing to be controlled.

Table 4 Anxiety, depression and cognitive disorder status in male and female group Full size table

Analysis of the influence factors associated with anxiety and depression in T2DM

Logistic regression analysis was used to identify the influence factors for anxiety and depression disorders in T2DM. According to the comparative analysis results between the two groups, it was found that sex ratio, the blood glucose fluctuation index, sleeping status and dietary habit were statistically significant. Therefore, sex ratio and other traditional risk factors such as smoking and alcohol consumption were considered as potential confounders. After controlling the confounders, the results showed that SDBG and sleep quality were associated with depression and anxiety disorders in T2DM (p = 0.040 and p < 0.001) and the OR values of these factors were 7.588 (1.097–52.069) and 4.428 (2.649–7.401), respectively. The male–female ratio, age, BMI, smoke, alcohol and dietary habit were not associated with depression and anxiety in T2DM (p = 0.801, p = 0.393, p = 0.337, p = 0.652, p = 0.489 and p = 0.828, separately). PPGE, LAGE and MBG had no effects on depression and anxiety in T2DM (p = 0.437, p = 0.180 and p = 0.836). The analysis results were shown in Table 5.