Association of depression with newly diagnosed type 2 diabetes among adults aged between 25 to 60 years in Karachi, Pakistan

Abstract

BackgroundThe combination of depression with type 2 diabetes is a public health problem. If diabetes is managed in its initial phase, the morbidity and mortality due to this combination may be prevented at an early stage. Therefore, we aimed to determine the association of depression with newly diagnosed type 2 diabetes among adults aged between 25 to 60 years in Karachi, Pakistan.MethodsFrom July 2006 to September 2007, a matched case control study (n = 592) was conducted in Civil Hospital, Karachi. Incident cases of type 2 diabetes (n = 296) diagnosed within one month were recruited from diabetic Out Patient Department (OPD) of Civil Hospital, Karachi. They were matched on age and sex with controls (n = 296), who were attendants sitting in the medical out patient department of the same hospital, recruited on the basis of absence of classical symptoms of polyuria and polydispia along with random blood glucose level of <200 mg/dl measured by a glucometer. Depression was identified by the Siddiqui Shah Depression Scale. Conditional logistic regression was applied to examine the association of depression and other independent variables with newly diagnosed type 2 diabetes at 95% C.I. and P < 0.05.ResultsThe study comprised of 592 subjects with 432(73%) males and 160(27%) females. Depression was significantly associated with newly diagnosed type 2 diabetes having mild level (mOR: 3.86; 95%CI: 2.22,6.71) and moderate to severe level (mOR: 3.41; 95%CI: 2.07,5.61). History of (h/o) gestational diabetes (mOR: 2.83; 95%CI: 1.05,7.64), family h/o diabetes (mOR: 1.59; 95%CI: 1.04,2.43), nuclear family (mOR: 1.75; 95%CI: 1.14,2.69), BMI (mOR: 1.62; 95%CI: 1.01,2.60 for obese and mOR: 2.12; 95%CI: 1.19,3.79 for overweight vs healthy to underweight) were also significantly associated with outcome, adjusting for age, sex, marital status, h/o smoking and h/o high BP.ConclusionsDiabetics should be screened simultaneously for depression and concomitant preventive strategies for gestational diabetes, nuclear family and high BMI should also be used to prevent mortality/morbidity among patients between 25 to 60 years of age.

A Cross Sectional Study on Associated Factors of Depression among Type 2 Diabetic Outpatients in Black Lion General Specialized Hospital, Addis Ababa, Ethiopia

“…246 million people in the world [3]. Type 2 diabetes accounts for 90 to 95% of the incidence of diabetes and is associated with a strong genetic predisposition as well as age, obesity and lack of physical activity [4].…”

“…Poor social support was the risk factor significantly associated with depression among type 2 diabetes patients. In a setting where recognition, screening and treatment levels remain low, health care providers need to focus their efforts on diagnosing, referring and effectively treating co-morbid depression in order to deliver rights-based and client-centered services for people in real needs.246 million people in the world [3]. Type 2 diabetes accounts for 90 to 95% of the incidence of diabetes and is associated with a strong genetic predisposition as well as age, obesity and lack of physical activity [4].The prevalence of diabetes is growing significantly throughout the world, and Sub-Saharan Africa is no exception.…”

Epidemiology of depression in diabetes: International and cross-cultural issues

“…In a study from Pakistan, the prevalence of depressive symptoms in people with newly diagnosed diabetes was found to be significantly higher four weeks after diagnosis of type 2 diabetes (Perveen et al, 2010), while a large prospective study from the USA found that the risk of depressive disorder increased in the two years after diagnosis of type 2 diabetes even in the absence of diabetes complications (O'Connor et al, 2009). On the other hand, a UK study found that the prevalence of depression was not significantly different from a normative sample in the first year after diagnosis, although a significant number of people had persistent depressive symptoms during that year (Skinner et al, 2010).…”

Spousal Support and Satisfaction with Healthcare Services as Moderators between Psychological Morbidity and Adherence to Diet in Type 2 Diabetes Patients

“…35,[43][44][45][46][47][48] In patients newly diagnosed with type 2 diabetes, an association between depression and the diagnosis of type 2 diabetes has been found, and this result may be explained by the necessary lifestyle changes required after diagnosis. 83,84 Depression also can lead to functional cognitive deficits, which, in turn, can interfere with remember to follow medical regimens, 44 explaining the importance of the moderating role of partners' support, by reminding the patient and reinforcing adher- ence to self-care behaviors. In addition, studies also showed that social support protects patients with chronic diseases, from psychological distress, and is associated with less symptoms.…”