Cross-lagged analysis of burnout and insomnia in older adult patients with diabetes mellitus complicated by hypertension: a 1-year longitudinal follow-up study

A significant bidirectional and vicious cycle relationship exists between disease management burnout and insomnia symptoms in older adult patients with diabetes and hypertension. Furthermore, T2 (6 months post-discharge) emerges as a critical window for intervention. It is recommended that gender-differentiated intervention strategies be implemented and that sleep management be integrated into the standardized diagnosis and treatment pathway for this patient population.