IntroductionVarious clinical studies have reported that clinical depression is a common co-morbidity in patients with type 2 diabetes mellitus. Depression can badly affect the lifestyle of diabetic patients and impair the proper management of diabetes mellitus. Therefore, there exists a need to identify risk factors of depression in diabetic patients especially in relation to various clinical parameters, glycemic control and diabetic microvascular complications.Materials and methodsIt was a cross-sectional study conducted in a tertiary care hospital in Pakistan from August 2018 to April 2019. We recruited type 2 diabetic patients and measured their various clinical and hematological parameters. We evaluated depression using Patient Health Questionnaire (PHQ-9) and evaluated its relationship with glycemic control, duration of diabetes, fasting lipid profile and presence of various diabetic microvascular complications.ResultsThere were 100 subjects in the study having a mean age 58.3 ± 12.4 (range: 36 - 71) years with a male to female ratio of 1:1.2. The mean duration of type 2 diabetes mellitus was 11.2 ± 9.2 years. The mean PHQ-9 score of the study population was 10.2 ± 8.1. The frequency of depression was found to be 40.0%. Depression was most frequently found in women and in patients between 40 to 60 years of age (60.0%). Depression was more common in patients with dyslipidemia (p-value = 0.0015). Patients with diabetic retinopathy, diabetic nephropathy and diabetic neuropathy were 3.8 times, 4.2 times and 2.1 times more likely to have clinical depression than the patients without these complications. Patients with glycated hemoglobin (HbA1c) worse than 7.5% had a significantly higher rate of depression than those whose HbA1c ranged from 6.5 - 7.5 % (p-value = 0.0028). Duration of diabetes mellitus did not significantly affect the frequency of depression in diabetic patients.ConclusionDepression is common in a large number of diabetic patients. Female gender, dyslipidemia, diabetic microvascular complications and impaired glycemic control are significantly associated with depression in diabetic patients.

Open Access Original Article

Objective: Cardiovascular diseases are 1.7 times more prevalent in patients with diabetes mellitus. The aim behind this study was to examine the correlation of glycosylated hemoglobin and complexity of coronary artery disease among middle aged population with diabetes mellitus Patients and Methods: This was a clinical prospective hospital-based comparative study carried out in the department of the cardiology department of Isra University Hospital Hyderabad for 10 months. 153 participants with diabetes mellitus having age ≥45 years both male and female and undergoing their first coronary angiography were included. Data were entered and analyzed by using Statistical Package for the Social Sciences version 21.0. Results: A total of 153 patients were finally analysed. Patients were divided into two groups; group I (HbA1c <6.5%, normal) and group II (HbA1c >6.5%, impaired). The mean age was slightly higher in group II 54.60 as compared to group I 53.65 years, respectively. The Syntax score was correlated with HbA1c levels in patients older than 45 years of age (r = 0.001; p >0.05). Moreover, the higher HbA1c levels were observed in every three categories of Syntax score but they were insignificantly associated with each other in patients with diabetes mellitus and having age more than 45 years. Conclusion: The HbA1c is insignificantly correlated with the complexity of coronary artery disease in diabetic patients having age more than 45 years. While only two factors, hypertension and increased triglycerides are significantly different among the HbA1c groups.