Prevalence and Clinical Correlators of Undiagnosed Significant Depressive Symptoms Among Individuals with Type 2 Diabetes In A Mediterranean Population

Abstract

To determine the frequency and clinical parameters, of clinically significant depressive symptoms among a type 2 diabetes (T2DM) sample from a Mediterranean area without an established diagnosis of depressive disorder (DD). 320 subjects with T2DM were recruited randomly from Primary-Care settings and the Endocrine Department from a tertiary center in Mallorca (Spain). 91 healthy individuals matched by age, gender and BMI were used as controls. All participating patients graded by the presence of DD by using the "Beck Depression Inventory" (BDI), considering pathological a cut-off score equal or greater than 16. 27.2% T2DM subjects had significant symptoms of DD compared with 12.1% in the control group (p<0.01). BDI score was higher among T2DM when compared with controls (12±9.6 vs. 7.4±5, p<00001). The proportion of females (68% vs. 37%, p<0.0001), subjects without an active job (68% vs. 45%, p=0.01) and singles (38% vs. 18%, p=0.007) was greater among T2DM with a BDI≥16. Subjects with criteria for DD had a higher BMI (31.99±5.96 vs. 30.53±5.62, p=0.03). Fasting plasma glucose was higher among T2DM with a BDI≥16 (162±70 vs. 147±45 mg/dl, p=0.02) as well as HbA1c levels (7.9±1.8% vs. 7.4±1.4%, p=0.01), triglycerides (203±183 vs. 161±103 mg/dl; p=0.03) and LDL-cholesterol (112±31 vs. 104±35 mg/dl; p=0.03). Gender, marital status, BMI and triglycerides were independently related to the presence of DD after a logistic regression model. Relevant depressive symptoms are more prevalent among Mediterranean T2DM subjects than in general population. Main clinical correlators of significant depressive symptoms are gender, marital status and BMI.

Retinal Microperimetry: A New Tool for Identifying Patients With Type 2 Diabetes at Risk for Developing Alzheimer Disease

“…In addition, retinal microperimetry is not influenced by noncognitive functions such as mood or depressive disorders, which could influence the results of neuropsychological tests. This is an important advantage given that the prevalence of depression is twofold higher in patients with type 2 diabetes than in the general population worldwide (37); depression has recently been reported in 27.5% of patients with type 2 diabetes in the Mediterranean population (38). This prevalence could be even higher in older adults with diabetes because depressive symptoms may be overlooked (39).…”

Methylglyoxal and Advanced Glycation End Products in Patients with Diabetes – What We Know so Far and the Missing Links

“…Diabetes is a complex heterogeneous disorder and a major risk factor for cardiovascular disease and stroke. Moreover, microvascular diabetic complications like diabetic nephropathy [1], retinopathy [2], and neuropathy [3] with consequences of diabetic foot syndrome [4], as well as other complications like psychological problems [5,6] and cancer [7] are associated with diabetes type 1 and type 2. Besides these established clinical complications, there is emerging evidence that diabetes is linked to pulmonary fibrosis as well [8].…”

Sintomatologia depresiva y control metabólico en pacientes ambulatorios portadores de diabetes mellitus tipo 2

“…La evidencia en relación a la frecuencia de síntomas depresivos en diabéticos presenta una gran dispersión, pues varía de 11% a 60% según distintas fuentes [22][23][24][25] . En este estudio, la frecuencia de síntomas depresivos entre diabéticos fue de 34,5%, similar a lo informado por Nicolau et al, quienes desarrollando una metodología similar (estudio de corte transversal en pacientes españoles de atención primaria, sin diagnóstico de trastorno depresivo mayor, evaluando síntomas depresivos con el Inventario de Depresión de Beck), corroboraron una frecuencia de 27,2%, con una diferencia entre sexos estadísticamente significativa (68% vs 37%) 26 . En cuanto a la frecuencia en países económicamente desarrollados, Jacob y Kostev reportaron que en una cohorte de pacientes de atención primaria con DM 2 en Alemania, a diez años de su diagnóstico, el 30,3% habían desarrollado síntomas depresivos 27 , menor que lo verificado para países como México (44%) 28 .…”

“…En el presente estudio, se comprobó que los portadores de DM 2 con sintomatología depresiva demuestran una menor adherencia farmacológica y un mayor nivel de descompensación metabólica, hallazgos consistentes con la literatura internacional [8][9][10]12,17,18,21,22,[25][26][27][28] pero que han sido estudiados escasamente a nivel nacional, pese a su relevancia como problemáticas de salud pública. De esta manera, puede abrirse camino a futuras investigaciones que contemplen otros pilares terapéuticos en DM 2 y depresión, con diseños metodológicos que permitan controlar los factores de confusión, y, posiblemente, demostrar relaciones de causalidad.…”