Evaluation of the relationship between chronotype and glycemic control, eating behavior and depression in individuals with type 2 diabetes

This study aimed to evaluate the relationship between chronotype and glycemic control, eating behavior and depression among individuals with type 2 diabetes. The research was conducted with a total of 114 individuals (31 males and 83 females) aged between 18 and 65 years, who attended the Istanbul University Cerrahpaşa Faculty of Medicine Diabetes and Obesity Clinic. Participants voluntarily completed a questionnaire including general information, dietary habits, anthropometric measurements, biochemical findings, 24-hour dietary recall, food frequency questionnaire, Morningness-Eveningness Questionnaire, Three-Factor Eating Questionnaire (TFEQ-R21) and Beck Depression Inventory (BDI). It was found that 28,1% of individuals were morning types, 58,8% were intermediate types and 13,2% were evening types. There were no statistically significant differences in biochemical parameters such as fasting blood glucose, HbA1c, total cholesterol, HDL cholesterol, LDL cholesterol and triglyceride levels based on chronotype (p>0,05). A significant relationship was observed between BMI and emotional eating behavior and uncontrolled eating behavior (p<0,05), where an increase in BMI correlated with increased tendencies towards emotional and uncontrolled eating behaviors. However, no relationship was found between BMI and cognitive restraint behavior (p>0,05). Female participants had higher scores for cognitive restraint and emotional eating behaviors compared to males (p<0,05), while males had higher scores for uncontrolled eating behaviors (p<0,05). There was a statistically significant relationship between cognitive restraint behavior scores and daily total energy intake (kcal), protein (g), carbohydrate (g), saturated fatty acids (g) and cholesterol (mg) intake levels (p<0,05), indicating that as cognitive restraint behavior increased, there was a decrease in intake of these dietary components. Emotional eating behavior scores were significantly associated with fat (%) and carbohydrate (g and %) intake levels (p<0,05), where an increase in emotional eating scores corresponded to a decrease in fat (%) intake and an increase in carbohydrate (g and %) intake. There was no significant relationship between uncontrolled eating behavior scores and energy and macronutrient intake (p>0,05). Depression scores were higher in females compared to males (p<0,01) and evening types showed higher depression levels compared to both intermediate and morning types (p<0,05). Evening types had significantly higher emotional eating and uncontrolled eating behavior scores compared to morning types (p<0,05). In conclusion, this study found that chronotype did not significantly affect glycemic control but did impact eating behavior and depression among individuals with type 2 diabetes. Evening chronotypes in particular should be evaluated comprehensively in terms of depression and eating behaviors using a multidisciplinary approach.