Frequency of Depression in Patients with Type 2 Diabetes Mellitus and its Relationship with Glycemic Control and Diabetic Microvascular Complications

Abstract

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.

Depressive Symptoms among Patients with Diabetes in Qatar: Frequency and Potential Determinants

“…Another study found a higher incidence of depression among women with diabetes was higher than that among men with diabetes [ 21 ]. Similar findings were reported in a cross sectional study conducted in Pakistan [ 26 ]. general Qatari population, females were also at higher risk of depression as compared to men [ 18 ].…”

Medical and socio-demographic determinants of depressive disorders in diabetic patients

“…The results of own study showed that an improper BMI value and the occurrence of diabetic neuropathy confirmed by medical examination are among factors exerting a significant effect on the occurrence of depression in diabetic patients. A similar relationship has been confirmed in studies by other researchers [29,30,31,32,33]. However, in the presented study, the level of increase in the risk of occurrence of depression was estimated.…”

Prognostic value of long-term trajectories of depression for incident diabetes mellitus in patients with stable coronary heart disease

“…Notably, patients with DM requiring glucose-lowering therapy and patients without diabetes but a prior myocardial infarction carry the same cardiovascular risk [ 18 ]. In addition, depression in CHD patients leads to lower adherence to oral hypoglycemic, antihypertensive, and lipid-lowering medication and unfavorable lifestyle choices [ 19 , 20 ]. Therefore, it is not surprising that patients with a previous CVE and DM are at especially high risk for a subsequent CVE.…”