Association Between Major Depression And Type 2 Diabetes Mellitus: A Meta-Analysis And Meta-Regression Of Observational Studies

Abstract

The purpose of this review was to identify the prevalence of major depression in individuals with type 2 diabetes by means of a systematic review and meta-analysis. An electronic search was conducted for relevant studies published from January 1988 to December 2014. Cross-sectional and case-control studies in adults that evaluated the prevalence of major depression in individuals with type 2 Diabetes Mellitus were included. Meta-regression and sensitivity analyses were used to identify the sources of heterogeneity. Publication bias was assessed using a funnel plot and Egger's test. After the selection process, 18 cross-sectional and four case-control studies were included in the meta-analysis. In total, the occurrence of major depression was investigated in 5554 patients with diabetes mellitus type 2. The prevalence of major depression varied from 6.67% (95% CI: 4.54% -9.38%) to 55.38% (95% CI: 42.53% -67.73%), with an overall average of 21.13% (95% CI: 15.80% -27.66%). In American continent, the prevalence was 20.83% (95% CI: 13.12% -31.43%; I²=96.8%), and in Europe it was 18.00% (95% CI: 8.58% -33.91%; I²=93.8%). Both were lower than the rate in Asia, which was 23.49% (95% CI: 15.63% -33.74%; I²=90.8%). Meta-regression analysis found no evidence that the analyzed cofactors represented the cause of the heterogeneity seen. The approximately symmetrical distribution of the points in Funnel Plot suggests an absence of publication bias that was confirmed by Egger's test (p=0.2345). Based on the data collected, we can infer that the prevalence of major depression in individuals with type 2 diabetes was high, independent of geographic location.

The Bidirectional Relationship between Diabetes and Depression: A Literature Review

“…Although Lin et al [ 8 ] in 2008 agreed with the finding that the risk of depression was slightly higher among diabetes patients than among patients without diabetes (ageand sex-adjusted OR, 1.38; 95% CI, 1.15–1.66), they reported that OR estimates between countries were not significantly different (P=0.54). This finding was supported by a recent meta-analysis of studies conducted in Europe, Asia, and the Americas by Lopes et al [ 9 ] in 2016. In this analysis, the prevalence of depression among patients with T2DM was higher than among nondiabetic individuals, independent of the geographic location (OR, 2.06; 95% CI, 1.13–3.74; P=0.0174).…”

A study to assess utility of diabetes anxiety depression scale in diabetic patients and to correlate its scores with glycaemic control

“…4,5 There is evidence that the prevalence of depression is moderately increased in prediabetic patients and in undiagnosed diabetic patients, and markedly increased in the previously diagnosed diabetic patients compared to normal glucose metabolism individuals. 6,7 Different environmental factors (epigenetic factors) may activate common pathways that promote DM2 and depression in the end. 8 One of the important factors are low socioeconomic status, poor sleep, lack of physical exercises and diet.…”