Prevalence of depression in adults with type 2 diabetes in the Basque Country: relationship with glycaemic control and health care costs

Abstract

BackgroundThe aim of the study was to estimate the prevalence of depression in the population diagnosed with diabetes type 2 and to test the hypothesis that the presence of depression in such cases was associated with a) worse glycaemic control, and b) higher healthcare costs.MethodsWe conducted a cross-sectional analysis, from 1st September 2010 to 31st August 2011, among patients with type 2 diabetes aged 35 years and over in the Basque Country. It was identified how many of them had also depression. The database included administrative individual level information on age, sex, healthcare costs, other comorbidities, and values of glycaemic control (HbA1c). Deprivation index variable was used as socioeconomic measure and, to observe the coexistent pathologies, all the patients diagnoses were categorized by Adjusted Clinical Groups. We used a measure of association, a logistic and a linear regression for analysis.Results12.392 (9.8%) of type 2 diabetes patients were diagnosed with depression, being the prevalence 5.2% for males and 15.1% for females. This comorbidity was higher among the most deprived population. There was no association between the presence of depression and glycaemic control. We estimated that the comorbidity average cost per patient/year was 516€ higher than in patients with just type 2 diabetes (P < 0.001) adjusted by the other covariates.ConclusionsWe did not find any relationship between depression and glycaemic control in patients with type 2 diabetes. However, the comorbidity was associated with significantly high healthcare costs compared to that of type 2 diabetes occurring alone, after adjusting by other illness. Thus, there is a need of more precise recognition, screening and monitoring of depression among diabetic population. Evidence-based treatment for depression should be included in type 2 diabetes clinical guidelines.

Prevalence of Depression, Anxiety and Cognitive Impairment in Patients with Type 2 Diabetes from the Central Part of Romania

“…This is in concordance with data from the general population, as well as from studies conducted in subjects with diabetes from other countries (e.g. 15.1% females vs. 5.2% males in Basque country and 32.3% females vs. 21.8% males in Lithuania, respectively) (9,11,31,32). The gender differences might be explained by hormonal or other biological factors, environmental experiences, including social demands and work burden or to psychological attributes and coping skills related to life events, but this is beyond the scope of the present work (33).…”

“…The reported prevalence of depression in subjects with T2D varied largely in similar studies in other geographical areas, from 9.8% in Basque region and 13% in Ethiopia to 40.3% in Malesia and Nepal and 48.27% in Mexico for example, and these differences could potentially be related to methodology, variations in characteristics of the study populations (e.g. duration of diabetes, age) or simply due to genetic/ethnic backgrounds (9,10,(12)(13)(14). In Central and Eastern European countries, the reported rates of depression in patients with diabetes are relatively high: 30.3% in Germany, 29.7% in Poland, 28.4% in Lithuania and 22% in Croatia (11,(28)(29)(30).…”

“…Data in the literature seem to indicate an increased prevalence of depression in adults with type 2 diabetes (T2D), which is generally considered twice higher than in subjects without T2D, women be-ing more affected than men (8). However, there are very large variations in reported prevalence, from about 10% to about 48% (9)(10)(11)(12)(13)(14). These might result from ethnic/geographical differences (developed vs. developing nations), type of study (controlled/uncontrolled) or possibly from methods of estimation (database research or active screening) (1,8).…”

The prevalence of diabetes-related complications and multimorbidity in the population with type 2 diabetes mellitus in the Basque Country

“…In this study, we could see a reduction in the rate of incidence of diabetes-related complications from 2007 to 2011. Adequate control of type 2 diabetes risk factors is high in the Basque population [ 29 ]. In addition, other studies have reported decreasing incidence of several complications such as amputations [ 26 , 30 , 31 ] and preventable hospitalisations [ 32 ].…”

Genetic overlap between type 2 diabetes and depression in Swedish and Danish twin registries

“…10, 11, 12 We therefore aimed to examine the genetic aetiology of the T2DM-depression association in two large population samples of twins using sex-limitation genetic modelling. In this study we combined the data from the Swedish and Danish twin registries, as they have a similar ethnic population structure.…”