Depression and Health-Related Quality of Life among Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study in Nepal

Abstract

BackgroundDiabetes is accompanied by a marked reduction in patient’s quality of life (QOL) and leads to higher disability-adjusted life years than most diseases. Depression further deteriorates QOL and is associated with poor treatment outcomes and lowered glycemic control in diabetes. We analysed the QOL and depression among the people living with diabetes in Nepal.MethodsWe conducted a cross-sectional survey among a random sample of 157 diabetic patients visiting diabetes clinic at a major teaching hospital in Kathmandu, Nepal. We administered the Nepali version of WHO-BREF for face to face interviews to obtain data on QOL scores. The Nepali version of Patient Health Questionnaire-9was also used to record responses on depression items.ResultsMore than half of the respondents (54.1%) experienced depression with mean PHQ-9 score of 6.15 ± 5.01 on a scale of 0–27. On a scale of 0 to 100, highest QOL mean score was reported in social relationship domain (57.32 ± 11.83), followed by environment domain (54.71 ± 7.74), psychological health (53.25 ± 10.32) and physical health (50.74 ± 11.83). After adjusting for other covariates, urban residence decreased the physical health score by 4.74 (β = -4.74, 95% CI: -8.664,-0.821), social relationship domain score by 3.420 (β = -3.420, 95% CI: -6.433,-0.406) and the overall QOL by 2.773 (β = -2.773, 95% CI: -5.295,-0.252). Having diagnosed with diabetes since more than 10 years increased physical health by 5.184 score points (β = 5.184; 95% CI: 0.753, 9.615).Similarly, having severe depression decreased social relation domain score by 6.053 (β = -6.053, 95% CI:-11.169,-.936).ConclusionHaving urban residence significantly decreased the physical health and social relation domain scores as well as the overall QOL scores. Similarly, having diagnosed since more than 10 years increased physical health domain score. Severe depression decreased social relationship domain score. Since depression affects QOL, we suggest early diagnosis and prompt treatment of depression in T2DM people as part of their routine primary care in Nepal.

An observational study to assess the health-related quality of life of type 2 diabetes mellitus patients attending a tertiary care hospital, Belagavi

“…In the present study, majority of the study participants were males (55.3%) which was similar to study done in Maharashtra whereas in many other studies majority of the study participants were females. [5][6][7][8][9] The mean age of study participants in this study was 53.95±10.84, similar results were seen in studies done in Nepal and Nairobi. 5,6 Whereas it was low compared to study done by Somappa et al 3 Nearly 28% of the study participants were illiterates which was same as seen in several other studies and it was high compared to other studies by Genga et al and Jain et al [5][6][7][8][9] Majority of the study participants (86.2%) were currently married as was seen in several other studies.…”

“…[5][6][7][8][9] The mean age of study participants in this study was 53.95±10.84, similar results were seen in studies done in Nepal and Nairobi. 5,6 Whereas it was low compared to study done by Somappa et al 3 Nearly 28% of the study participants were illiterates which was same as seen in several other studies and it was high compared to other studies by Genga et al and Jain et al [5][6][7][8][9] Majority of the study participants (86.2%) were currently married as was seen in several other studies. [5][6][7][8][9] More than half of the study subjects (57%) were consuming any of the form of tobacco whereas this was very high compared to study done in Nepal and Maharashtra.…”

“…6,7 In this study only 26.7% of them gave history of alcohol consumption which was less compared to study done by Jain et al, which showed it to be 98.6%. 7 Family history of DM was present in 26% of the study participants. Whereas study done by Mishra showed it to be 40%.…”

“…5,6 Whereas it was low compared to study done by Somappa et al 3 Nearly 28% of the study participants were illiterates which was same as seen in several other studies and it was high compared to other studies by Genga et al and Jain et al [5][6][7][8][9] Majority of the study participants (86.2%) were currently married as was seen in several other studies. [5][6][7][8][9] More than half of the study subjects (57%) were consuming any of the form of tobacco whereas this was very high compared to study done in Nepal and Maharashtra. 6,7 In this study only 26.7% of them gave history of alcohol consumption which was less compared to study done by Jain et al, which showed it to be 98.6%.…”

“…[5][6][7][8][9] More than half of the study subjects (57%) were consuming any of the form of tobacco whereas this was very high compared to study done in Nepal and Maharashtra. 6,7 In this study only 26.7% of them gave history of alcohol consumption which was less compared to study done by Jain et al, which showed it to be 98.6%. 7 Family history of DM was present in 26% of the study participants.…”