Investigation of the Relationship Between Chronic Insomnia and the Onset of Type 2 Diabetes Mellitus and Its Effects on Sexual Performance Quality in Patients Visiting the Kader Hospital and Examination Center in Mazar-I-Sharif, Afghanistan

Abstract

Introduction: Type 2 Diabetes Mellitus is one of the most significant public health issues, characterized by insulin resistance and impaired insulin secretion. Risk factors such as overweight, physical inactivity, and poor nutrition play a crucial role in its development. Alongside these factors, sleep disturbances, particularly chronic insomnia and sleep apnea, can exacerbate the onset and control of blood glucose levels.

There exists a strong correlation between chronic insomnia, chronic diabetes, and sexual dysfunction. Blood glucose control and vascular/neurogenic factors act as mediators or modulators between sleep and sexual performance.

Literature Review: Approximately 90% of individuals with diabetes have Type 2 Diabetes Mellitus. Behavioral and environmental factors such as weight gain, obesity, and lack of exercise are primary contributors to Type 2 Diabetes. The risk of sexual dysfunction in diabetic patients is heightened due to the onset of neuropathic, vascular, hormonal issues, and chronic diseases such as kidney disease, hypertension, and hyperlipidemia. Sexual dysfunction is the most common complication of diabetes affecting both genders.

Diabetes is recognized as a major non-communicable disease and is the eighth leading cause of death worldwide. According to the Ministry of Public Health of Afghanistan, there are 422 million individuals globally affected by diabetes, of which 199 million are women. Estimates suggest this figure may rise to 600 million by 2035.

The number of individuals affected by diabetes, or hyperglycemia, worldwide exceeded 450 million in 2017. Engaging in a healthy lifestyle can reduce the risk of developing Type 2 Diabetes Mellitus.

Researchers at a university in Japan have recently found that even sleeping less than six hours a night increases the risk of developing diabetes.

The tools used in the study included:

1. Demographic questionnaire
2. Sleep quality questionnaire
3. Self-efficacy scale in diabetes management
4. Female sexual function index

Research Findings: Among 200 diabetic patients, 101 were female with an average age of 52.8 ± 3.3 years, and 99 were male with an average age of 54.9 ± 7.5 years. Of these, 23.5% had a university education, while 76.5% were below diploma level. The average duration of illness was 9.4 ± 5.7 years, with over half of the patients (56.5%) having had diabetes for less than 10 years. The average number of children was 3.2 ± 1.5. A majority of patients (38%) had high blood lipids, and 32.5% had no other diseases aside from diabetes.

Discussion and Results: The results indicated a positive correlation between sexual dysfunction and sleep disturbances, which can be predicted based on self-efficacy.

In other studies, although this finding has not always been consistently observed, having positive experiences (such as positive thoughts, pleasant feelings, and enjoyment) plays a significant role in diabetes management and improved sleep quality.