Prevalence of depression in consecutive patients with type 2 diabetes mellitus of 5-year duration and its impact on glycemic control

Cynthia Susan Mathew, Mini Dominic, Rajesh Isaac, Jubbin J Jacob, Cynthia Susan Mathew, Mini Dominic, Rajesh Isaac, Jubbin J Jacob

Abstract

Context: Type 2 diabetes mellitus doubles the odds of suffering from depressive illness. Co-morbid depression is associated with poorer outcomes in diabetes mellitus in terms of glycemic control, medication adherence, quality of life, physical activity, and blood pressure control.

Aim: The present study aims to estimate the prevalence of depression among a consecutive group of patients with type 2 diabetes and assess its impact on glycemic and blood pressure control.

Setting: Outpatient department of the endocrinology department of a university affiliated teaching hospital in north India.

Subjects: Consecutive adult patients (18-65 years) with type 2 diabetes mellitus of over 5-year duration with no prior history of psychiatric illnesses or intake of anti-depressants.

Materials and methods: A semi-structured questionnaire was used for demographic data, HbA1c was obtained to assess glycemic control, and blood pressure was recorded twice during patient interview to assess blood pressure control. Depression was assessed with the Major Depression Inventory and scores obtained were classified as consistent with mild, moderate and severe depression. Data was analyzed with SPSS v16, and multiple logistical regression test was done to compare the effect of depression on glycemic control after adjusting for age and sex.

Results: Of the 80 patients interviewed, 31 (38.8%) had depressive symptoms. Among them 20 (25%) had mild depression, 10 (12.5%) had moderate depression, and 1 (1.3%) had severe depression.

Conclusions: Over one third of patients with type 2 diabetes mellitus of over 5-year duration had depressive symptoms. The presence of depressive symptoms was associated with a significant worsening of glycemic control.

Keywords: Depression; HbA1c; glycemic control; type 2 diabetes mellitus.

Conflict of interest statement

Conflict of Interest: None declared.

References

    1. Gupta R, Misra A. Type 2 Diabetes in India: Regional Disparities. Br J Diab Vasc Dis. 2007;7:12–6.
    1. Golden SH, Lazo M, Carnethon M, Bertoni AG, Schreiner PJ, Diez Roux AV, et al. Examining a bidirectional association between depressive symptoms and diabetes. JAMA. 2008;299:2751–9.
    1. Knol MJ, Twisk JW, Beekman AT, Heine RJ, Snoek FJ, Pouwer F. Depression as a risk factor for the onset of type 2 diabetes mellitus. A meta-analysis. Diabetologia. 2006;49:837–45.
    1. Medved V, Jovanović N, Knapić VP. ‘The comorbidity of diabetes mellitus and psychiatric disorders’. Psychiatr Danub. 2009;21:585–8.
    1. Ali S, Stone MA, Peters JL, Davies MJ, Khunti K. The prevalence of co-morbid depression in adults with Type 2 diabetes: A systematic review and meta-analysis. Diabet Med. 2006;23:1165–73.
    1. Hermanns N, Scheff C, Kulzer B, Weyers P, Pauli P, Kubiak T, et al. Association of glucose levels and glucose variability with mood in Type 1 diabetic patients. Diabetologia. 2007;50:930–3.
    1. Shaban MC, Fosbury J, Kerr D, Cavan DA. The prevalence of depression and anxiety in adults with Type 1 diabetes. Diabet Med. 2006;23:1381–4.
    1. Anderson RJ, Freedland KE, Clouse RE, Lustman PJ. The prevalence of comorbid depression in adults with diabetes. Diabetes Care. 2001;24:1069–78.
    1. Lustman PJ, Clouse RE. Depression in diabetic patients: The relationship between mood and glycemic control. J Diabetes Complications. 2005;19:113–22.
    1. Simon GE, Katon WJ, Lin EH, Rutter C, Manning WG, Von Korff M, et al. Cost-effectiveness of systematic depression treatment among people with diabetes mellitus. Arch Gen Psychiatry. 2007;64:65–72.
    1. Gonzalez JS, Peyrot M, McCarl LA, Collins EM, Serpa L, Mimiaga MJ, et al. Depression and diabetes treatment nonadherence: A meta- analysis. Diabetes Care. 2008;31:2398–403.
    1. Von Korff M, Katon W, Lin EH, Simon G, Ludman E, Oliver M, et al. Potentially modifiable factors associated with disability among people with diabetes. Psychosom Med. 2005;67:233–40.
    1. Schram MT, Baan CA, Pouwer F. Depression and quality of life in patients with diabetes: A systematic review from the European depression in diabetes (EDID) research consortium. Curr Diabetes Rev. 2009;5:112–9.
    1. Koopmans B, Pouwer F, de Bie RA, van Rooij ES, Leusink GL, Pop VJ. Depressive symptoms are associated with physical inactivity in patients with type 2 diabetes.The DIAZOB Primary Care Diabetes study. Fam Pract. 2009;26:171–3.
    1. American Diabetes Association. Clinical Practice Recommendations. Diabetes Care. 2010;1:S1–103.
    1. Cuijpers P, Dekker J, Noteboom A, Smits N, Peen J. Sensitivity and specificity of the Major Depression Inventory in outpatients. BMC Psychiatry. 2007;7:39.
    1. Konstantinidis A, Martiny K, Bech P, Kasper S. A comparison of the major depression inventory (MDI) and the beck depression inventory (BDI) in severely depressed patients. Int J Psychiatry Clin Pract. 2011;15:56–61.
    1. Balhara Y, Sagar R. Correlates of anxiety and depression among patients with type 2 diabetes mellitus. Indian J Endocr Metab. 2011;15:50–4.
    1. Raval A, Dhanaraj E, Bhansali A, Grover S, Tiwari P. Prevalence and determinants of depression in type 2 diabetes patients in a tertiary care centre. Indian J Med Res. 2010;132:195–200.
    1. Khuwaja AK, Lalani S, Dhanani R, Azam IS, Rafique G, White F. Anxiety and depression among outpatients with type 2 diabetes: A multi-centre study of prevalence and associated factors. Diabetol Metab Syndr. 2010;2:72.
    1. Aina Y, Susman JL. Understanding comorbidity with depression and anxiety disorders. J Am Osteopath Assoc. 2006;106(5 Suppl 2):S9–14.
    1. Bouwman V, Adriaanse MC, van’t Riet E, Snoek FJ, Dekker JM, Nijpels G. Depression, anxiety and glucose metabolism in the general Dutch population: The new Hoorn study. PloS One. 2010;5:e9971.
    1. Collins MM, Corcorant P, Perry IJ. Anxiety and depression symptoms in patients with diabetes. Diabet Med. 2009;26:153–61.
    1. Skaff MM, Mullan JT, Almeida DM, Hoffman L, Masharani U, Fisher L. Daily negative mood affects fasting glucose in type 2 diabetes. Health Psychol. 2009;28:265–72.
    1. Eren I, Erdi O, Ozcankaya R. Relationship between blood glucose control and psychiatric disorders in type II diabetic patients. Turk Psikiyatri Derg. 2003;14:184–91.
    1. Richardson LK, Egede LE, Mueller M, Echols CL, Gebregziabher M. Longitudinal effects of depression on glycemic control in veterans with Type 2 diabetes. Gen Hosp Psychiatry. 2008;30:509–14.
    1. Heckbert SR, Rutter CM, Oliver M, Williams LH, Ciechanowski P, Lin EH, et al. Depression in relation to long-term control of glycemia, blood pressure, and lipids in patients with diabetes. J Gen Intern Med. 2010;25:524–9.
    1. Petrak F, Herpertz S. Treatment of depression in diabetes: An update. Curr Opin Psychiatry. 2009;22:211–7.
    1. Katon WJ, Lin EH, Von Korff M, Ciechanowski P, Ludman EJ, Young B, et al. Collaborative care for patients with depression and chronic illnesses. N Engl J Med. 2010;363:2611–20.
    1. Bogner HR, Morales KH, de Vries HF, Cappola AR. Integrated management of type 2 diabetes mellitus and depression treatment to improve medication adherence: A randomized controlled trial. Ann Fam Med. 2012;10:15–22.

Source: PubMed

Sponsorzy i współpracownicy

Warunki medyczne

Interwencje lekowe

3
Subskrybuj