{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T05:50:17Z","timestamp":1791352217278,"version":"4.3.1"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Clin. Diabetes Healthc."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Examine the associations between demographic, behavioral, and psychosocial characteristics and fasting blood glucose among adults with type 2 diabetes (T2D) at a regional diabetes clinic in the Dominican Republic (DR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study enrolled 65 adults with T2D who received care from a non-profit regional diabetes clinic in the DR. Participants completed interviewer-administered questionnaires to assess sleep quality, perceived stress, diet quality, health-related quality-of-life, and physical activity (PA). Fasting blood glucose was measured using capillary testing by a clinic nurse. A complete-case network analysis was conducted to examine conditional associations among study variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Only 15 participants (23%) had fasting blood glucose within the 80\u2013130 mg\u2022dL\n                      <jats:sup>-1<\/jats:sup>\n                      target range for people with T2D, with significantly higher levels among men (243 \u00b1 93 vs. 170 \u00b1 64 mg\u2022dL\n                      <jats:sup>-1<\/jats:sup>\n                      , p&amp;lt;0.001). Participants reported poor sleep quality (98%), moderate-to-high stress (97%), and low consumption of fruits and vegetables. Although 95% of participants met or exceeded recommended PA volume, activity was primarily from occupational and household tasks performed at light-to-moderate intensity. PA was the most connected variable within the network, and was inversely related to fasting blood glucose.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this resource-constrained DR clinic sample, poor fasting blood glucose coexisted with substantial sleep, stress, and diet deficiencies, despite substantial low-to-moderate-intensity PA. The network findings support diabetes self-management interventions to improve physical activity, sleep hygiene, stress reduction, and diet education, to improve glycemic control in low- and middle-income countries. Future prospective network analyses may identify context-specific behavioral targets for improving glycemic control in similar populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcdhc.2026.1978637","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T04:53:40Z","timestamp":1791348820000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Behavioral and psychosocial correlates of fasting blood glucose in a resource-constrained diabetes clinic in the Dominican Republic: an exploratory network analysis"],"prefix":"10.3389","volume":"7","author":[{"given":"Amerigo","family":"Rossi","sequence":"first","affiliation":[{"name":"Interdisciplinary Health Sciences, New York Institute of Technology","place":["Old Westbury, NY, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00f3nica O.","family":"Rossi","sequence":"additional","affiliation":[{"name":"Health and Nutrition Sciences, Brooklyn College","place":["New York, NY, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurelina C.","family":"Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Centro Regional Contra la Diabetes","place":["Nagua, Dominican Republic"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Boolani","sequence":"additional","affiliation":[{"name":"Human Performance and Nutrition Research, Oklahoma State University","place":["Stillwater, OK, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001040","article-title":"Comprehensive management of cardiovascular risk factors for adults with type 2 diabetes: A scientific statement from the American Heart 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