INCIDENT INSOMNIA AND STRESS-RELATED MENTAL HEALTH OUTCOMES AFTER NUTRITIONAL SUPPLEMENT INITIATION IN ADULTS WITH TYPE 2 DIABETES: A MULTI-TIME-WINDOW COHORT STUDY USING THE TRINETX GLOBAL COLLABORATIVE NETWORK
Author(s)
Thi Kim Hien Nguyen, MD, MSc, Jane C-J Chao, PhD, Septi Melisa, PhD, Jason C. Hsu, PhD;
Taipei Medical University, Taipei City, Taiwan
Taipei Medical University, Taipei City, Taiwan
OBJECTIVES: To compare the incidence of insomnia, anxiety, depression, and stress-related disorders among type 2 diabetes mellitus (T2DM) adults with or without nutritional supplements.
METHODS: A retrospective cohort study was conducted using TriNetX Global Collaborative Network. T2DM adults were divided into nutritional supplement (any of vitamin D, vitamin C, vitamin B/folate, zinc, magnesium, omega-3 fatty acids, melatonin/neuroactive amino acids, or herbal extracts) and non-user groups using 1:1 propensity score matching. Incidence was defined as new diagnoses after the index date and evaluated at months 1, 3, 6, years 1 and 3. Cumulative incidence, risk ratios, and risk differences were estimated. Hazard ratios were calculated by time-to-event analyses. A secondary matched analysis was performed to compare outcomes in T2DM adults treated with sodium-glucose co-transporter 2 (SGLT2) inhibitor or glucagon-like peptide 1 (GLP-1) receptor agonist in the nutritional supplement group.
RESULTS: After matching, the subjects were 325,034 in each group. At month 1, the nutritional supplement group had lower cumulative incidence of insomnia (0.39% vs 0.76%), anxiety (0.28% vs 0.52%), and depression (0.23% vs 0.49%), but similar rates of stress-related disorders compared to the non-users. At years 1 and 3, the nutritional supplement group had lower incidence for all outcomes. The nutritional supplement group was associated with lower hazards of insomnia (HR 0.573-0.621), anxiety (HR 0.610-0.667), and depression (HR 0.531-0.634) from month 1 to year 3, and lower hazards of stress-related disorders (HR 0.729-0.847) after month 3. In the secondary analysis (11,797 matched pairs), SGLT2 inhibitor users had a lower risk of insomnia than GLP-1 receptor agonist users.
CONCLUSIONS: The nutritional supplement group was associated with lower incidence of insomnia, anxiety, depression, and stress-related disorders. SGLT2 inhibitor users was correlated with a lower risk of insomnia compared to GLP-1 receptor agonist users in the nutritional supplement group
METHODS: A retrospective cohort study was conducted using TriNetX Global Collaborative Network. T2DM adults were divided into nutritional supplement (any of vitamin D, vitamin C, vitamin B/folate, zinc, magnesium, omega-3 fatty acids, melatonin/neuroactive amino acids, or herbal extracts) and non-user groups using 1:1 propensity score matching. Incidence was defined as new diagnoses after the index date and evaluated at months 1, 3, 6, years 1 and 3. Cumulative incidence, risk ratios, and risk differences were estimated. Hazard ratios were calculated by time-to-event analyses. A secondary matched analysis was performed to compare outcomes in T2DM adults treated with sodium-glucose co-transporter 2 (SGLT2) inhibitor or glucagon-like peptide 1 (GLP-1) receptor agonist in the nutritional supplement group.
RESULTS: After matching, the subjects were 325,034 in each group. At month 1, the nutritional supplement group had lower cumulative incidence of insomnia (0.39% vs 0.76%), anxiety (0.28% vs 0.52%), and depression (0.23% vs 0.49%), but similar rates of stress-related disorders compared to the non-users. At years 1 and 3, the nutritional supplement group had lower incidence for all outcomes. The nutritional supplement group was associated with lower hazards of insomnia (HR 0.573-0.621), anxiety (HR 0.610-0.667), and depression (HR 0.531-0.634) from month 1 to year 3, and lower hazards of stress-related disorders (HR 0.729-0.847) after month 3. In the secondary analysis (11,797 matched pairs), SGLT2 inhibitor users had a lower risk of insomnia than GLP-1 receptor agonist users.
CONCLUSIONS: The nutritional supplement group was associated with lower incidence of insomnia, anxiety, depression, and stress-related disorders. SGLT2 inhibitor users was correlated with a lower risk of insomnia compared to GLP-1 receptor agonist users in the nutritional supplement group
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
CO3
Topic
Clinical Outcomes
Topic Subcategory
Comparative Effectiveness or Efficacy, Relating Intermediate to Long-term Outcomes
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity), STA: Nutrition