Sex-specific Association of Meal Frequency, Dinner Time, Dinner-to-Sleep Interval, and Sleep Duration at Night on Glucometabolic Control in People with Type 2 Diabetes Mellitus

A bstract Background: Effects of meal- and sleep-related factors on glucometabolic control among South-Asian people with type 2 diabetes mellitus (T2DM) were inadequately reported, especially in the context of sex. Objective: This study evaluated the sex-specific associations of meal- and sleep-related factors on glucometabolic control among people with T2DM. Materials and Methods: From February to December 2025, we enrolled 694 adults with T2DM across four hospitals. Data collection included meal- and sleep-related histories, physical measurements (height, weight, waist circumference, and blood pressure [BP]), and glucometabolic parameters (e.g., glycated hemoglobin, plasma glucose, fasting lipid profiles, and body indices). Findings were categorized and evaluated against established clinical recommendations to identify abnormal health values. Results: Obesity and dyslipidemia were more frequent in females compared with males. More than three daily meals were associated with higher odds for hypertriglyceridemia (odds ratio [OR] = 2.0) in males but lower odds for low high-density lipoprotein-cholesterol (OR = 0.4) in females. Bedtime after 11 pm was associated with higher odds for general (OR = 2.1) and central obesity (OR = 1.9) only in males. Dinner–bedtime interval up to 2 h was associated with higher odds for high total cholesterol (TC), both for males (OR = 2.4) and females (OR = 1.8), and uncontrolled systolic BP (OR = 1.7) in females. Sleep duration at night below 6 h was associated with higher odds for uncontrolled diastolic BP (OR = 2.8) and overall uncontrolled BP (OR = 2.5) in males, and higher odds for high TC (OR = 1.7) in females. Conclusion: Meal- and sleep-related factors may be associated with poor glucometabolic status with distinctive sex-specific association in people with T2DM.