<p>Factors Associated with Untreated Depression Among Type 2 Diabetic Patients at Halaba Kulito Hospital, South Ethiopia: A Cross-Sectional Study</p>

Abstract

Background: Depressed type 2 diabetes mellitus patients (T2DM) show poorer compliance with treatment and self-care recommendations than non-depressed T2DM patients. This contributes to poor prognosis and accelerates diabetic-related complications including poor glucose regulation, diabetic retinopathy, neuropathy, nephropathy, and escalated healthcare expenditure. Objective: This study aimed to determine the magnitude of untreated depression and associated factors among people living with T2DM at outpatient diabetic clinic in Halaba Kulito General Hospital, Southern Ethiopia. Methods: Institution-based cross-sectional study was conducted from November 1 to December 15, 2019 at Halaba Kulito Hospital, Southern Ethiopia. We collected data by faceto-face interview with patient record review. A total of 418 type 2 diabetic patients were systematically selected and interviewed using a pretested structured questionnaire. We used a composite score of nine-items Patient Health Questionnaire (PHQ-9) to assess depression status. Descriptive statistics was used to summarize respondents' background characteristics. Logistic regression analysis was done to identify associated factors with the outcome variable. Levels of significance were set at 5% (P<0.05). Results: The finding depicted that 120 (29.3% with 95% Confidence interval (CI) = 25.0%, 34.0%) study participants satisfied diagnostic criteria for depression disorder. After controlling for confounding effect, we identified being hypertensive (Adjusted Odds Ratio (AOR) = 5.66; 95% CI: 3.24, 9.86), having no child (AOR = 3.32; 95% CI: 1.88, 5.86), and poor glycemic control (AOR = 6.23; 95% CI: 3.65, 10.54) as risk factors for untreated depression among people with type 2 diabetes. Conclusion: Findings of this study indicate that untreated depression among type 2 diabetic patients is high. Poor glycemic control, not having a child and having hypertension were among significantly associated factors with depression. These results suggest much need for interventions, including strong medication adherence and self-care activities such as exercise or healthful diet for optimal glycemic control.

Depression and Glycemic Control among Adult Type 2 Diabetic Patients: A Crossectional Study in a Comprehensive Specialized Hospital, Jigjiga, Ethiopia

“…Poor glycemic control in T2DM was about twice (AOR = 1.93; 95% CI = 1.05, 3.53) as risky for depression compared to those who had good glycemic control. This nding is consistent with a large-scale study in 21 developing countries (15), independent studies in Peru (46), Indonesia (41), Egypt (16), North Sudan (37), and Halaba (17). In contradict to this nding, study conducted in America (47), Ire land (48), a meta-analysis in China (33),…”

“…However, the current prevalence nding was relatively higher than a recent large hospital-based study result from 21 developing countries, which reported 33.1% (15), and a cohort study in China, which reported 29% depression prevalence among T2DM patients (33). The current prevalence is also higher than results of studies done in United States 26.8% (34),Vietnam 23.2% (35), Ghana 31.3% (36), North Sudan 35.6% (37), and Ethiopian studies in Mizan 37.0% (38) and Halaba 29.3% (17). Different age groups in a study of Ghana and using a higher PHQ-9 cut-off point in studies conducted in Mizan and Halaba, respectively might explain the lower depression prevalence in these settings.…”

“…Despite the controversial association between depression and glycemic control, several cross-sectional studies across the world, including Ethiopia, showed a signi cant association between poor glycemic control and depression (15)(16)(17). It is highest in the Gulf countries and Africa, particularly in Ethiopia, where more than two-thirds of T2DM patients have poor glycemic control (18)(19)(20).…”

“…Although some efforts have been made to estimate the prevalence of depression and its associated predictors among T2DM patients in Ethiopia, limited studies have addressed the association of depression with glycemic control. These studies did not measure glycemic control using the standard measurement, HbA1c, which better indicates the chronic level of hyperglycemia (17,22). Hence, measuring the prevalence of depression and its sociodemographic predictors, clinical predictors, and glycemic control remains a critical undertaking.…”

Prevalence and Risk Factors of Depression among Adult Type 2 Diabetic Patients at Al-Jemaih Diabetic Center, Dongola, Northern State, Sudan, 2019

“…Regarding the duration of T2DM, symptoms of depression tend to increase early after diagnosis and decrease over a few years and then rise with the longer duration of DM, making a j-shaped curve; the rise with the duration of DM may be related to frailty associated with old age and longer duration [22]. Many studies have demonstrated the significant association between depression in T2DM and diabetes-related complications, poor glycemic control, and lack of exercise [23][24][25][26][27]. The family history as a risk factor may be explained by a potential common genetic susceptibility to both T2DM and depression [28], but no study has mentioned a family history of psychiatric illness as a risk factor for depression in T2DM.…”