Path Analysis on the Effect of Stress, Sleep Quality, and Hypertension on Type 2 Diabetes Mellitus Incidence in the 30–60 years Age Group in Medan City

Abstract

Non-communicable diseases are still the leading cause of death worldwide, affecting not only the elderly but also the productive age group. Type 2 diabetes mellitus (DM) is one of the non-communicable diseases whose prevalence continues to rise, including in Indonesia. North Sumatra Province also experienced an increase in DM prevalence , with the highest number of cases in Medan City. The development of type 2 DM is a complex process and is associated with several risk factors, one of which is psychological stress . This study aims to analyze the effect of stress on the incidence of type 2 DM in the 30-60 year s age group in Medan City directly and indirectly through sleep quality and hypertension. The research method used a case control design with a sample size of 68 cases and controls each. Data analysis was carried out univariately and multivariately using a path analysis model. The results showed that there is a direct effect between stress (b=0.892; 95% CI=0.149-1.636; p=0.019) on the incidence of type 2 DM in the 30 -60 years age group in Medan City. Stress increases the risk of type 2 DM indirectly through poor sleep quality (b=0.886; 95% CI=0.188-1.583; p=0.013) and hypertension (b=0.859; 95% CI=0.117-1.602; p= 0.023) . In addition, sleep quality (b=0.820; 95% CI=0.076-1.565; p=0.031) and hypertension (b=1.046; 95% CI=0.249-1.841; p=0.010) also have a direct effect on type 2 DM. Avoiding and managing stress, getting enough and regular sleep, and controlling blood pressure can help prevent type 2 DM. Keyword: Hypertension, Sleep Quality, Stress, Type 2 Diabetes Mellitus