{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T21:10:41Z","timestamp":1793049041170,"version":"4.5.0"},"reference-count":106,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"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. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diabetes mellitus remains a significant global health burden, particularly in low- and middle-income countries and in war and conflict zones. This study aimed to examine the prevalence of poor glycemic control and its association with post-traumatic stress disorder (PTSD), stress, dietary patterns in individuals with type 1 and type 2 diabetes in primary healthcare settings in southern Palestine from October 1, 2025, to December 1, 2025. It also aimed to assess the factors associated with poor glycemic control in these individuals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>A cross-sectional analytical study design was utilized for a sample of 531 patients with diabetes mellitus. Data were collected using self-reported questionnaires, including the PTSD Checklist for DSM-5 (PCL-5), Food Frequency Questionnaire, and Perceived Stress Scale (PSS-10). For HbA1c test results, the information was obtained from the patients\u2019 records, and the test were conducted within the last 2\u202fmonths at the latest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The results showed that 76.3% of participants had poor glycemic control. Participants with type 2 diabetes (AOR: 2.348,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.015), those with PTSD (AOR: 5.455,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001), and individuals experiencing moderate to high levels of stress were associated with poor glycemic control (AOR: 3.172,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001). Additionally, individuals who followed an average dietary pattern were less likely to experience poor glycemic control (AOR: 0.054,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The findings revealed a high prevalence of poor glycemic control. Therefore, it is essential that psychological interventions and dietary counseling be made available at primary health care centers to support patients with diabetes mellitus.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1783847","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T04:19:03Z","timestamp":1780287543000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["The association between poor glycemic control and PTSD in patients with diabetes mellitus in primary healthcare in Palestine"],"prefix":"10.3389","volume":"13","author":[{"given":"Muna","family":"Ahmead","sequence":"first","affiliation":[{"name":"Faculty of Public Health, Al-Quds University","place":["Jerusalem, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hala","family":"Taqatqa","sequence":"additional","affiliation":[{"name":"Faculty of Public Health, Al-Quds University","place":["Jerusalem, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maisa","family":"Nabulsi","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy, Al-Quds University","place":["Jerusalem, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,1]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1007\/s13167-018-0133-y","article-title":"Diabetes care in figures: current pitfalls and future scenario","volume":"9","author":"Duarte","year":"2018","journal-title":"EPMA J"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"109119","DOI":"10.1016\/j.diabres.2021.109119","article-title":"IDF diabetes atlas: global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045","volume":"183","author":"Sun","year":"2022","journal-title":"Diabetes Res Clin 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