Depression and glycaemic control among type 2 diabetes patients: a cross-sectional study in a tertiary healthcare facility in Ghana

Akpalu, Josephine; Yorke, Ernest; Ainuson-Quampah, Joana; Balogun, Williams

doi:10.1186/s12888-018-1933-2

Cited by 43 publications

(51 citation statements)

References 45 publications

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“…Participants rated the extent to which they have experienced symptoms over the previous week on a 4-point Likert scale ranging from 0 (did not apply to me at all) to 3 (applied to me very much, or most of the time). The cut-off scores for depressive symptoms were developed according to the DASS manual: normal (0-9), mild (10-13), moderate (14)(15)(16)(17)(18)(19)(20), severe (21)(22)(23)(24)(25)(26)(27), and extremely severe (≥28). Participants were considered to suffer from depressive disorders if they scored ≥ 10.…”

Section: Measurementsmentioning

confidence: 99%

Mediators of the association between low socioeconomic status and poor glycemic control among type 2 diabetics in Bangladesh

Rahman

Nakamura

Hasan

et al. 2020

Sci Rep

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in contrast to developed countries 8 , leisure time physical activity in Bangladesh 13 is more prevalent in the lower SES group. Thus, adverse health-related behaviors might mediate the relationship between low SES and poor glycemic control. Among the comorbid conditions, being overweight/obese was generally associated with an increased likelihood of poor glycemic control in type 2 diabetics 15. Studies also noted that comorbid conditions such as hypertension 16 and depressive symptoms 17 are correlated with poorer glycemic control. Besides, hypertension, obesity, and depressive symptoms often exhibit socioeconomic patterning 18,19 , low prevalence of hypertension and overweight/obesity 18 and high prevalence of depressive symptoms 19 were observed in the low SES group. Therefore, these comorbid conditions may potentially mediate the relationship between low SES and poor glycemic control. Apart from adverse-health related behaviors and comorbid conditions, non-adherence to essential health service-related practices including irregular scheduled visits to diabetes clinic, not practicing self-monitoring of blood glucose concentrations, and reliance on alternative medicine have been known to contribute to poor glycemic control 14,20-22. Several observational studies found that underuse of recommended preventive services associated with poor glycemic control 20,21. Studies also indicated that patients who were not self-monitored their blood glucose 14 and rely on alternative medicine 22 had higher odds of having poorly controlled blood glucose compared to those who self-monitored their blood glucose and do not rely on alternative medicine. Furthermore, these essential health service-related practices vary by SES. In comparison to the high-SES group, people in the low-SES group are more likely to use low-cost and often less-effective alternative medicines and to experience barriers in the timely use of health care services according to their need 23. Accordingly, non-adherence to essential health service-related practices has been proposed as potential mediators of the association between low SES and poor glycemic control. To our knowledge, there has been only a single study regarding to examine the mediators contributing to socioeconomic inequality in glycemic control 24 , which showed that avoidance coping during a stressful event related to their diabetes (eg, to give up trying to deal with the event or to refuse to believe it is happening) and depressive symptoms mediated the relationship between SES and glycemic control. However, the contributions of mediators relating low SES to poorer glycemic control may differ according to context, suggesting the need for research in different settings. To date, there have been no studies in developing countries to assess the mediators relating low SES to poorer glycemic control. Therefore, evidence on socioeconomic disparities in glycemic control and potential mediators to mitigate this relationship is required. This study was performed to examine potential modifiable factor...

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Section: Measurementsmentioning

confidence: 99%

Mediators of the association between low socioeconomic status and poor glycemic control among type 2 diabetics in Bangladesh

Rahman

Nakamura

Hasan

et al. 2020

Sci Rep

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“…Depression is associated with chronic physical illnesses and negatively affects health outcomes [ 1 , 2 ]. Few affected people access appropriate treatment as depression is often undiagnosed.…”

Section: Introductionmentioning

confidence: 99%

Detection and prevalence of depression among adult type 2 diabetes mellitus patients attending non-communicable diseases clinics in Lilongwe, Malawi

Udedi

Pence

Stewart

et al. 2020

Int J Ment Health Syst

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Background Depression is associated with chronic physical illnesses and negatively affects health outcomes. However, it often goes undiagnosed and untreated. We investigated the prevalence of depression among adult type 2 diabetes mellitus (T2DM) patients attending non-communicable diseases (NCD) clinics in Lilongwe, Malawi, and estimated the level of routine detection by NCD clinicians. This study set out to determine the prevalence of major depression and its detection among adult type 2 diabetes mellitus (T2DM) patients attending NCD clinics in Lilongwe, Malawi. Methods In a cross-sectional study design, 323 T2DM patients aged ≥ 18 years were screened for depression with the Patient Health Questionnare-9 (PHQ-9) followed by diagnostic assessment with the Structured Clinical Interview for DSM-IV (SCID). We analysed the association between presence of major depression and sociodemographic factors using logistic regression. Results Three quarters of the participants (76%) were females. The participants’ ages ranged from 21–79 years. Of the 323 participants, 58 (18%) met criteria for DSM-IV major depression. None of the cases of major depression had been identified by the NCD clinicians. Major depression was found not to be significantly associated with any of the sociodemographic factors. Conclusions We found that depression is common among NCD clinic attendees with T2DM in Malawi, and poorly detected by NCD clinicians. Given the high prevalence and challenges in clinical identification, integration of depression screening with a standardized validated tool should be a high priority so as to link patients to appropriate services.

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“…Most notably, evidence shows that the relationship between depression and T2DM has been found to be bi-directional; 9,12,13 the likelihood of depression in (T2DM) patients is approximately double that found in the overall population 13 whereas depressed patients have 60% increased risk of developing type 2 diabetes. 1,14 Depressed type 2 diabetic patients show poorer compliance with treatment and self-care recommendations than non-depressed T2DM patients. This contributes to poor prognosis and accelerates diabetic-related complications including poor glucose regulation, diabetic retinopathy, neuropathy, nephropathy, and escalated healthcare expenditure.…”

Section: Introductionmentioning

confidence: 99%

<p>Factors Associated with Untreated Depression Among Type 2 Diabetic Patients at Halaba Kulito Hospital, South Ethiopia: A Cross-Sectional Study</p>

Azeze¹,

Adema²,

Adella³

et al. 2020

DMSO

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Background: Depressed type 2 diabetes mellitus patients (T2DM) show poorer compliance with treatment and self-care recommendations than non-depressed T2DM patients. This contributes to poor prognosis and accelerates diabetic-related complications including poor glucose regulation, diabetic retinopathy, neuropathy, nephropathy, and escalated healthcare expenditure. Objective: This study aimed to determine the magnitude of untreated depression and associated factors among people living with T2DM at outpatient diabetic clinic in Halaba Kulito General Hospital, Southern Ethiopia. Methods: Institution-based cross-sectional study was conducted from November 1 to December 15, 2019 at Halaba Kulito Hospital, Southern Ethiopia. We collected data by faceto-face interview with patient record review. A total of 418 type 2 diabetic patients were systematically selected and interviewed using a pretested structured questionnaire. We used a composite score of nine-items Patient Health Questionnaire (PHQ-9) to assess depression status. Descriptive statistics was used to summarize respondents' background characteristics. Logistic regression analysis was done to identify associated factors with the outcome variable. Levels of significance were set at 5% (P<0.05). Results: The finding depicted that 120 (29.3% with 95% Confidence interval (CI) = 25.0%, 34.0%) study participants satisfied diagnostic criteria for depression disorder. After controlling for confounding effect, we identified being hypertensive (Adjusted Odds Ratio (AOR) = 5.66; 95% CI: 3.24, 9.86), having no child (AOR = 3.32; 95% CI: 1.88, 5.86), and poor glycemic control (AOR = 6.23; 95% CI: 3.65, 10.54) as risk factors for untreated depression among people with type 2 diabetes. Conclusion: Findings of this study indicate that untreated depression among type 2 diabetic patients is high. Poor glycemic control, not having a child and having hypertension were among significantly associated factors with depression. These results suggest much need for interventions, including strong medication adherence and self-care activities such as exercise or healthful diet for optimal glycemic control.

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Depression and glycaemic control among type 2 diabetes patients: a cross-sectional study in a tertiary healthcare facility in Ghana

Cited by 43 publications

References 45 publications

Mediators of the association between low socioeconomic status and poor glycemic control among type 2 diabetics in Bangladesh

Mediators of the association between low socioeconomic status and poor glycemic control among type 2 diabetics in Bangladesh

Detection and prevalence of depression among adult type 2 diabetes mellitus patients attending non-communicable diseases clinics in Lilongwe, Malawi

<p>Factors Associated with Untreated Depression Among Type 2 Diabetic Patients at Halaba Kulito Hospital, South Ethiopia: A Cross-Sectional Study</p>

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