{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T23:35:55Z","timestamp":1785540955118,"version":"3.56.0"},"reference-count":0,"publisher":"Rambam Health Corporation","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rambam Maimonides Med J"],"abstract":"<jats:p>Background: Sleep disturbances, particularly insomnia, are increasingly recognized as behavioral determinants of type 2 diabetes (T2DM). However, their contribution to validated diabetes risk scores beyond traditional sociodemographic and lifestyle factors remains insufficiently explored.\n\nObjective: To examine the association between insomnia severity, sociodemographic variables, lifestyle habits, and estimated T2DM risk using three validated non-invasive risk assessment scales.\n\nMethods: A cross-sectional study was conducted among 84,898 Spanish workers aged 18\u201369 years undergoing occupational health evaluations (2021\u20132024). Sociodemographic and behavioral data were collected through standardized questionnaires, including adherence to the Mediterranean diet (MEDAS-14), physical activity (IPAQ-SF), and smoking status. Insomnia was assessed using the Insomnia Severity Index (ISI). Diabetes risk was estimated using three validated non-invasive risk-assessment tools: the Finnish Diabetes Risk Score, the QDScore\/QDiabetes, and the Trinidad Risk Assessment Questionnaire for Type 2 Diabetes Mellitus. As these instruments were developed and validated in different populations, comparisons of absolute risk categories across scales should be interpreted with caution. Multivariable logistic regression models adjusted for age, sex, social class, smoking, diet, and physical activity were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).\n\nResults: Severe insomnia was associated with approximately 2.1\u20132.6-fold higher odds of high estimated diabetes risk across all three scales in the pooled analyses, with significant trends across categories of insomnia severity (all P for trend &lt;0.001). This association persisted across sex and activity strata. Adding ISI modestly improved model discrimination (\u0394AUC \u2248 +0.015; P\u22640.003) and reclassification (continuous net reclassification improvement [NRI], 6.5%\u20138.1%).\n\nConclusions: Insomnia severity was independently associated with higher estimated risk of T2DM beyond measured sociodemographic and lifestyle determinants. Incorporating sleep health\u2014via brief tools such as the ISI\u2014into diabetes risk assessment could enhance early prevention strategies in clinical and occupational settings.<\/jats:p>","DOI":"10.5041\/rmmj.10579","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T20:43:36Z","timestamp":1785530616000},"page":"e0019","source":"Crossref","is-referenced-by-count":0,"title":["Insomnia as an Independent Behavioral Correlate of Estimated Type 2 Diabetes Risk: Evidence from Three Validated Risk Assessment Scales"],"prefix":"10.5041","volume":"17","author":[{"given":"Jos\u00e9 Luis","family":"Ribes Valles","sequence":"first","affiliation":[{"name":"Clinical Analysis Laboratory, Son Llatzer Hospital, Palma, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro Juan","family":"T\u00e1rraga L\u00f3pez","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Castilla-La Mancha, Albacete, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7439-8117","authenticated-orcid":false,"given":"\u00c1ngel Arturo","family":"L\u00f3pez Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry ADEMA University School, Palma, Spain and Primary Care Balearic Islands Health Service, Palma, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Coll Campayo","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry ADEMA University School, Palma, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Busquets-Cort\u00e9s","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry ADEMA University School, Palma, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Ignacio","family":"Ram\u00edrez-Manent","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry ADEMA University School, Palma, Spain; Primary Care Balearic Islands Health Service, Palma, Spain; and Faculty of Medicine, University of the Balearic Islands, Palma, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2983","published-online":{"date-parts":[[2026,7,31]]},"container-title":["Rambam Maimonides Medical Journal"],"original-title":[],"link":[{"URL":"https:\/\/www.rmmj.org.il\/userimages\/4104\/1\/PublishFiles\/4716Article.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T20:43:37Z","timestamp":1785530617000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.rmmj.org.il\/issues\/72\/articles\/4716"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,31]]},"references-count":0,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,7,31]]}},"URL":"https:\/\/doi.org\/10.5041\/rmmj.10579","relation":{},"ISSN":["2076-9172"],"issn-type":[{"value":"2076-9172","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,31]]}}}