The effects of mask applied aromatherapy on allergic rhinitis symptoms, fatigue, and quality of life related to allergic rhinitis in the COVID-19 era: a randomized controlled trial.

Diabetes accounted for 11.1% of diabetes-related deaths worldwide 2025 [] and was the seventh leading cause of death in Korea in 2024, accounting for 21.7% of total deaths []. Type 2 diabetes mellitus (T2DM), which accounts for 90%~95% of all diabetes cases, is being diagnosed at increasingly younger ages. As a result, the duration of disease tends to be prolonged, increasing exposure to chronic hyperglycemia, hypoglycemia, and various diabetes-related complications [,]. The prevalence of depressive and anxiety symptoms in patients with diabetes is approximately two to four times higher than that in the general population []. Physiologically, diabetes-related metabolic dysregulation has been associated with alterations in brain function, while impaired peripheral glucose regulation may contribute to depressed mood []. Comorbid depression in patients with diabetes is known to negatively affect quality of life, increase functional disability and medical costs, and worsen overall disease prognosis []. More than 25% of patients with T2DM experience depression []. When T2DM and depression coexist, the risks of complications, noncommunicable diseases, and mortality are significantly higher []. Depression in patients with T2DM is closely associated with the long-term burden of disease self-management, including continuous blood glucose monitoring, adherence to dietary recommendations, regular physical activity, and pharmacological therapy. Previous studies have demonstrated that depression adversely affects diabetes management and treatment adherence, leading to poorer health outcomes in this population [,]. Therefore, identifying and appropriately managing depression is essential for improving treatment adherence and overall disease outcomes in patients with T2DM. In this context, objective and clinically applicable measures are required to assess and manage depression in individuals with diabetes []. Glycemic control is a core component of diabetes management, and glycated hemoglobin (HbA1c) is widely used as a standard indicator of long-term glycemic control. According to clinical guidelines, poor glycemic control in T2DM is defined by HbA1c levels of 6.5% or higher [,]. Common indicators of glycemic control in diabetes include fasting blood glucose (FBG), fructosamine, and HbA1c. FBG reflects plasma glucose levels during fasting and is commonly used for diabetes diagnosis and monitoring. Fructosamine reflects the glycation of serum proteins and indicates average glycemic status over the previous 2~3 weeks, influenced primarily by albumin turnover. It is particularly useful in clinical conditions such as hemoglobinopathies, anemia, or chronic kidney disease, where HbA1c measurements may be less reliable due to shortened red blood cell lifespan; in such cases, fructosamine may provide a more sensitive indicator of short-term glycemic changes []. HbA1c reflects average blood glucose levels over the preceding 2~3 months and is widely used for predicting diabetes-related complications and long-term outcomes [].