Research Summary
Analyzed using Evidence Intelligence™

CBTI improves sleep regularity and reduces anxiety in T2D patients

Last updated July 11, 2026

Key finding

CBTI group had significantly improved sleep regularity compared to the HE group (mean difference -21.84 minutes (95% CI -41.64, -2.05, p=0.031).

This study evaluated the impact of Cognitive Behavioral Therapy for Insomnia (CBTI) on sleep regularity and anxiety in individuals with Type 2 Diabetes. CBTI showed significant improvements in sleep regularity and anxiety symptoms compared to Health Education (HE).

Quick read

Study at a glance

The essential study design details in one scan.

EvidenceScore™

Moderate

Study type

RCTs

Follow-up

Medium-Term (3–12 mo)

Risk of bias

Some Concerns

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Plain-language summary

What this paper says

A plain-language read of the study's main message and where it applies.

Study focus

This study evaluated the impact of Cognitive Behavioral Therapy for Insomnia (CBTI) on sleep regularity and anxiety in individuals with Type 2 Diabetes. CBTI showed significant improvements in sleep regularity and anxiety symptoms compared to Health Education (HE).

Clinical relevance

Improving sleep regularity and reducing anxiety are crucial for managing Type 2 Diabetes effectively. This study suggests that CBTI could be a beneficial intervention for this population, potentially leading to better overall health outcomes and quality of life.

Keep in mind

Self-reported sleep quality did not differ between groups. The study may have limited generalizability due to specific population characteristics. Effectiveness of interventions beyond the 8-week period remains unclear.

Published in

Journal Reference

Publication details and source links for this paper.

Similan K, Sirimon R, Chutintorn S, et al. Cognitive Behavioral Therapy for Insomnia Improves Sleep Regularity and Reduces Anxiety in Type 2 Diabetes. Journal of the Endocrine Society. 2025;9(Suppl 1):bvaf149.1237. doi:10.1210/jendso/bvaf149.1237

Main Effects

CBTI group showed significantly improved sleep regularity compared to HE group.

CBTI group had a greater reduction in anxiety symptoms than HE group.

CBTI group experienced a greater reduction in fasting plasma glucose levels compared to HE group.

Evidence network

How this study fits

Understand where this research contributes within the broader evidence network.

Evidence Context

This study contributes evidence to Behavioral counseling, Remote nutrition education on low-carbohydrate diet and Anxiety score, Fasting Plasma Glucose (FPG), Sleep quality, and 1 more.

Primary intervention

Behavioral counseling

Primary outcomes

  • Anxiety score
  • Fasting Plasma Glucose (FPG)
  • Sleep quality

Evidence relationships

Intervention and outcome relationships this study adds to the evidence network.

8
Evidence pairs
8
Relationships
2
Evidence topics
contributes_evidence

Editorial context

Why this study matters

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Evidence network role

This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.

Moderate contributionModerate confidenceNetwork score: 68

2

Related topics

8

Evidence pairs

169

Related studies

High relevance in at least one topic

Why it is useful

  • Contributes to 8 evidence relationships
  • Includes primary outcome data
  • Linked to 2 direct semantic evidence topics

Topic contributions

Evidence topic

Contributes evidence

Evidence topic

Contributes evidence

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Primary evidence

Evidence relationship

Diabetes Self-Management Education and Support (DSMES) Programs and Fasting Glucose

Related evidence

Evidence relationship

Diabetes Self-Management Education and Support (DSMES) Programs and Quality of Life Outcomes

Follow evidence

Evidence relationship

Diabetes Self-Management Education and Support (DSMES) Programs and Mental Health

Follow evidence

Core evidence

Study findings

The primary outcomes reported in this study.

Anxiety score

Behavioral counseling → Anxiety score

Behavioral counseling → Anxiety score

Evidence Intelligence™
ImpactScore™
100
Very Positive
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Unlock full evidence details

Fasting Plasma Glucose (FPG)

Behavioral counseling → Fasting Plasma Glucose (FPG)

Behavioral counseling → Fasting Plasma Glucose (FPG)

Evidence Intelligence™
ImpactScore™
100
Very Positive
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Unlock full evidence details

Sleep quality

Behavioral counseling → Sleep quality

Behavioral counseling → Sleep quality

Evidence Intelligence™
ImpactScore™
75
Positive
EvidenceScore™
Moderate
Score 69 · Based on 2 studies
ConsistencyScore™
35
mixed
Supporting studies: Based on 2 studies
Unlock full evidence details

Sleep regularity

Behavioral counseling → Sleep regularity

Behavioral counseling → Sleep regularity

Evidence Intelligence™
ImpactScore™
100
Very Positive
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Unlock full evidence details

Anxiety score

Remote nutrition education on low-carbohydrate diet → Anxiety score

Remote nutrition education on low-carbohydrate diet → Anxiety score

Evidence Intelligence™
ImpactScore™
50
Neutral
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Unlock full evidence details

Fasting Plasma Glucose (FPG)

Remote nutrition education on low-carbohydrate diet → Fasting Plasma Glucose (FPG)

Remote nutrition education on low-carbohydrate diet → Fasting Plasma Glucose (FPG)

Evidence Intelligence™
ImpactScore™
50
Neutral
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Unlock full evidence details

Sleep quality

Remote nutrition education on low-carbohydrate diet → Sleep quality

Remote nutrition education on low-carbohydrate diet → Sleep quality

Evidence Intelligence™
ImpactScore™
50
Neutral
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Unlock full evidence details

Sleep regularity

Remote nutrition education on low-carbohydrate diet → Sleep regularity

Remote nutrition education on low-carbohydrate diet → Sleep regularity

Evidence Intelligence™
ImpactScore™
50
Neutral
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Unlock full evidence details

Unlock full evidence analysis

Create a free account to access effectiveness ratings, evidence strength and depth scores, consistency analysis, and direct links to all supporting studies.

evidence suggest

Evidence Suggest

  • CBTI improved sleep regularity by 21.84 minutes (p=0.031).
  • CBTI reduced anxiety symptoms significantly compared to HE.
  • CBTI led to a decrease in fasting plasma glucose levels by 34.27 mg/dL (p=0.001).
who this applies

Who this applies to

  • Adults diagnosed with Type 2 Diabetes.
  • Individuals experiencing insomnia and anxiety.
keep in mind

Keep in Mind

  • Results are specific to the 8-week intervention period.
  • Findings may not apply to individuals outside the study demographics.
  • Further research is needed to assess long-term effects of CBTI.
between the lines

Between the Lines

  • Self-reported sleep quality did not differ between groups.
  • The study may have limited generalizability due to specific population characteristics.
  • Effectiveness of interventions beyond the 8-week period remains unclear.

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Connected Evidence

Explore related studies, evidence collections, and research questions.

Relationships organized using the Dediabetes Evidence Intelligence™ framework.

This study contributes to evidence on Diabetes Self-Management Education and Support (DSMES) Programs and Quality of Life Outcomes, Diabetes Self-Management Education and Support (DSMES) Programs and Mental Health.

Related evidence relationships

Explore in Evidence Archive

This study contributes to the evidence on the following intervention-outcome relationships.

Questions answered by this study

Generated from the study's connected evidence using Evidence Intelligence™.

Does Diabetes Self-Management Education and Support (DSMES) Programs improve fasting glucose?

Strong Evidence

Diabetes Self-Management Education and Support (DSMES) Programs may improve Fasting Glucose.

ConsistencyScore™: Results are generally consistent across studies.

Ranked evidence signals

  1. 1

    Fasting Plasma Glucose (FPG)

    EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on 8 supporting studies with generally consistent results and a positive effect signal.

Limitations

  • Population details are unavailable.
8 supporting studiesUpdated: Jul 2026

Does Diabetes Self-Management Education and Support (DSMES) Programs improve quality of life outcomes?

Strong Evidence

Diabetes Self-Management Education and Support (DSMES) Programs may improve Quality of Life Outcomes.

ConsistencyScore™: Results are consistent across studies.

Ranked evidence signals

  1. 1

    Sleep quality

    EvidenceScore™ Moderate | EvidenceScore™ 69.0 | moderate positive | ConsistencyScore™ Mixed | 1 study

Why this answer: This answer is based on 9 supporting studies with consistent results and a positive effect signal.

Limitations

  • Population details are unavailable.
9 supporting studiesUpdated: Jul 2026

Does Diabetes Self-Management Education and Support (DSMES) Programs improve mental health?

Strong Evidence

Diabetes Self-Management Education and Support (DSMES) Programs appears to improve Mental Health.

ConsistencyScore™: Results are consistent across studies.

Ranked evidence signals

  1. 1

    Anxiety score

    EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on 3 supporting studies with consistent results and a positive effect signal.

Limitations

  • Population details are unavailable.
3 supporting studiesUpdated: Jul 2026

Does Behavioral counseling improve sleep regularity?

Emerging Evidence

Behavioral counseling appears to improve Sleep regularity.

ConsistencyScore™: Consistency cannot yet be determined from the available evidence.

Ranked evidence signals

  1. 1

    Sleep regularity

    EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

  • Only one supporting study is available.
  • Consistency cannot yet be determined.
  • Population details are unavailable.
1 supporting studyUpdated: Jul 2026
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