Evaluation of the Predominant Dietary Pattern and Sleep Disorders in Obese Diabetic Patients and Non-diabetic Obese Individuals : Short title: The Dietary Pattern and Sleep Disorders in Diabetics.

BACKGROUND: Objective: Diabetes mellitus is a chronic metabolic disorder and a major public health concern worldwide, particularly in developing countries. Dietary habits and sleep quality are important factors influencing metabolic health and diabetes outcomes. This study aimed to compare dietary patterns and sleep disorders among obese patients with diabetes and obese individuals without diabetes. MATERIALS AND METHODS: This quasi-experimental study was conducted in 2023 on 140 obese adults, including 70 patients with diabetes and 70 non-diabetic individuals, who attended the endocrinology subspecialty clinic of Imam Khomeini Hospital in Ahvaz, Iran. Dietary intake was assessed using a 147-item Food Frequency Questionnaire (FFQ), while sleep quality and daytime sleepiness were evaluated using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS), respectively. Healthy, traditional, and Western dietary patterns were identified and compared between the groups. RESULTS: No significant difference was observed in mean age between the two groups. However, diabetic participants had significantly higher body weight than non-diabetic subjects (P=0.02). Sleep quality was poor in both groups, but diabetic patients had significantly worse PSQI scores than non-diabetic individuals (13.35±1.26 vs. 9.41±0.98, P=0.001). Consumption of fruits, vegetables, and low-fat dairy products did not differ significantly between groups, whereas intake of high-fat dairy products was significantly higher among diabetic patients (P=0.03). Adherence to the traditional and Western dietary patterns was associated with a 4.42-fold and 3.63-fold increased risk of type 2 diabetes, respectively, while no significant association was found for the healthy dietary pattern. CONCLUSION: Obese patients with diabetes exhibit poorer sleep quality and less favorable dietary habits than obese non-diabetic individuals. These findings highlight the importance of promoting healthy dietary patterns and improving nutritional awareness to support diabetes prevention and management.