Maternal psychopathic traits prospectively predict youth callous-unemotional traits.

Type 2 diabetes mellitus (T2DM) is one of the chronic metabolic diseases contributing most substantially to the global disease burden (). With population aging, the increasing prevalence of obesity, and ongoing lifestyle changes, the number of individuals affected by T2DM continues to rise. Chronic complications resulting from suboptimal glycemic control, including cardiovascular disease, nephropathy, retinopathy, and neuropathy, further increase the long-term burden on both patients and healthcare systems (). Therefore, optimizing lifestyle management beyond pharmacological treatment remains a critical component of comprehensive T2DM prevention and care. Dietary control and regular physical activity are fundamental strategies in T2DM management (, ). Higher dietary quality may improve the overall structure of energy intake, reduce consumption of refined carbohydrates and saturated fats, and increase intake of dietary fiber and high-quality protein, thereby contributing to metabolic processes related to insulin sensitivity, weight management, and postprandial glucose fluctuations (, ). Physical activity, in turn, may be associated with better long-term glycemic control by promoting skeletal muscle glucose uptake, improving insulin resistance, modulating body fat distribution, and reducing chronic low-grade inflammation (, ). Previous studies have consistently suggested that healthier dietary patterns and higher levels of physical activity are associated with lower HbA1c levels, which is why they are recommended as core lifestyle strategies in major diabetes management guidelines (). However, in real world clinical practice, a substantial gap remains between knowing lifestyle recommendations and adhering to them over the long term. Many patients with T2DM show considerable individual variability in glycemic control despite receiving similar dietary and exercise guidance (). Such variability may be related not only to conventional factors, such as age, sex, diabetes duration, obesity status, and medication use, but also to individual differences in psychological self-regulation and behavioral implementation (). Dietary control and exercise management are not merely external behavioral exposures; rather, they require patients to continuously make choices, inhibit impulses, maintain goals, and adjust behaviors in daily life (, ). Therefore, explaining differences in glycemic control solely on the basis of dietary intake or exercise duration may not fully capture the complexity of lifestyle management in T2DM.