Impact of Glycemic Control on Depression among Type 2 Diabetic Patients

Abstract

Background: Type 2 diabetes mellitus (T2DM) have demonstrated rates of psychological distress, particularly depression tend to be higher than the general population, but are usually comparable to those reported in individuals with other chronic diseases. Objectives: To investigate the prevalence and determinants, particularly the glycemic control, of depression in patients with T2DM attending family medicine and diabetic clinics in Makkah MOH hospitals and primary care centers. Subjects and Methods: A cross-sectional study was conducted among adult diabetic type 2 patients (aged over 18 years) attending Family Medicine and Diabetic clinics, Ministry of health hospitals and primary care centers in Makkah Al-Mukarramah, KSA. Two general hospitals and 4 primary health care centers were randomly selected to be involved in the study by a simple random technique. Data were collected using a questionnaire composed of three main parts. The first part includes patient`s demographics, the second part composed of diabetes-related variables: insulin treatment, compliance with therapy, presence of complications. In addition to data collected from patient`s file. The third part included the Arabic version of the Depression Anxiety Stress Scale (DASS). Results: The study included 352 patients out of a targeted 380 with a response rate of 92.6%. Their age ranged between 19 and 81 years with a mean±SD of 48.3±14.4 years. Almost two-thirds of them (64.2%) were females. Prevalence of depression among type 2 diabetic patients was 64.2%; it was severe and extremely severe among 11.4% and 15.1% of them, respectively. Multivariate logistic regression analysis revealed that patients aged over 60 years were more likely to be depressed as compared to those aged 19-30 years (Adjusted OR=3.57, 95% CI=1.36-9.38, p=0.010). Patients with borderline fasting blood glucose level were at almost double fold risk for depression compared to those with good fasting blood glucose level (Adjusted OR=2.09, 95% CI=1.19-3.66, p=0.010). Compared to patients who reported perfect compliance with DM therapy, those who never compliant with DM therapy were at three-folded risk to develop depression (Adjusted OR=3.21, 95% CI=1.36-4.07, p=0.042). Female diabetic patients were more likely to have depression compared to male patients (Adjusted OR=2.55, 95% CI=1.56-4.18, p<0.001). Glycosylated hemoglobin was not significant and removed from the final model. Conclusion: Almost two-thirds of type 2 diabetic patients were depressed. According to glycated hemoglobin, diabetes was poorly or very poorly controlled among almost one-quarter of patients. However, glycemic control was not significantly associated with depression.

Depression and Associated Risk Factors Among Type 2 Diabetic Patients: A Cross Sectional Study on a Convenience Sample from the Diabetic Center, Khamis Mushait; Saudi Arabia

“…This prevalence rate falls in the middle of the rates’ range that has been reported by previous studies, from 14.5% 36 to 64%. 37 It goes along with our previous studies on Saudi population with diabetes 32 , 38 and with large meta-analysis in 2001 that found the prevalence of co morbid depression was significantly higher in clinical (32%) than in community (20%) samples, and by using self-report questionnaires (31%) than by standardized diagnostic interviews (11%). 33 …”