Risk and protective factors of co-morbid depression in patients with type 2 diabetes mellitus: a meta analysis

Abstract

The aim from this paper is to identify the main influencing factors of co-morbid depression among T2DM (Type 2 Diabetes Mellitus) patients and to provide reliable evidence for relative researches. A systematic review and meta-analysis of risk factors for co-morbid depression in T2DM was performed on all retrieved studies through an observational research of network database. Data were analyzed by Review Manager 5.3 from the extracted results, the heterogeneity index of the studies was determined using Chi-squared I 2 tests and on the basis of heterogeneity, a fixed or random effect model was used to estimates the pooled effect of each influencing factor. Fourteen observational studies containing total of 82,239,298 cases that have been identified. Diabetic complications (OR = 2.91; 95%CI, 1.76-4.82, p < 0.0001), insulin use (OR = 1.71; 95%CI, 1.18-2.48, p = 0.005), education status (OR = 1.91; 95%CI, 1.30-2.81, p = 0.001) were confirmed as risk factors, while regular exercising (OR = 0.51; 95%CI, 0.27-0.96, p = 0.04), gender (OR = 0.56; 95%CI, 0.47-0.65, p < 0.0001), marital status (OR = 0.53; 95%CI, 0.34-0.83, p = 0.005), current social status (OR = 0.64; 95%CI, 0.47-0.88, p = 0.006) were confirmed as protective factors of co-morbid depression in the patients with T2DM. Subgroup analysis claimed age (≥60 years) was a risk factor and smoking was protective factor for co-morbid depression in the patients with T2DM. Being female, have diabetic complications, insulin use, education level less than secondary are risk factors. However, doing regular exercise, being married and on work are protective factors of co-morbid depression in patients with T2DM. As to the other influencing factors should be further studied.

Pathophysiology linking depression and type 2 diabetes: Psychotherapy, physical exercise, and fecal microbiome transplantation as damage control

“…15% and 6.1% respectively (Brandão & Cardoso, 2018). Regular exercise poses as a protective factor in patients with coexisting diabetes and depression (Simayi & Mohemaiti, 2019), and is associated with enhanced QoL (Jing et al., 2018). Furthermore, vigorous rather than moderate physical activity is revealed to serve as a vigilant element against diabetes, obesity, and hypertension (Dumith et al., 2019).…”

Investigation of early and lifetime clinical features and comorbidities for the risk of developing treatment-resistant depression in a 13-year nationwide cohort study

“…Several clinical and psychosocial factors have been reported to be associated with poor treatment response in patients with MDD, including poor treatment adherence, physical and psychiatric comorbidities, bipolarity, and high level of neuroticism [ 6 , 12 – 14 ]. Physical comorbidities, including diabetes [ 15 , 16 ], heart diseases [ 17 ], functional gastrointestinal disorders (FGIDs) [ 18 ], thyroid disease [ 19 ], systemic lupus erythematosus (SLE) [ 20 ], and rheumatoid arthritis [ 21 ], have been implicated in the development and prognosis of common mental disorders, especially mood disorders. In addition, a group of anxiety disorders (including panic disorder, generalized anxiety disorder, social anxiety disorder, and obsessive-compulsive disorder), attention deficit hyperactivity disorder (ADHD), substance use disorders (SUDs), and personality disorders were found to be more prevalent in patients with MDD [ 22 – 25 ], or predictive of worse outcomes or slower remission [ 24 ].…”

Factors Associated with Depressive Symptoms in Korean Adults with Diabetes Mellitus: A Cross-Sectional Study

“…However, in this study, female sex and inferior education's association with depressive symptoms were significant in the univariate analyses. Although, the literature reviews investigating the association between depression and diabetes have shown these as risk factors for depression [18,41] Regarding health-related behavioral factors, fair and poor subjective health conditions and high perceived stress were significantly associated with depressive symptoms. In particular, poor subjective health conditions and high perceived stress significantly increased the risk of depressive symptoms.…”

“…A large population-based study demonstrated that comorbidity and physical impairment were correlated with depression in people with diabetes [17]. Additionally, a meta-analysis of 14 cross-sectional studies reported that female sex, insulin use, diabetes complications, low educational level, physical inactivity, living alone, and unemployment were significant risk factors for depressive symptoms in people with diabetes [18]. A community-based epidemiological study investigating 3540 Korean adults with type 2 diabetes in a city identified low income, unemployment, current smoking, use of oral hypoglycemic medications or insulin, and physical inactivity as significant factors associated with depressive symptoms [19].…”