TYPE II DIABETES AND PREVALENCE OF DEPRESSION IN PATIENTS ATTENDING PRAKASH INSTITUTE OF MEDICAL SCIENCE AND RESEARCH HOSPITAL

Abstract

South Asia, Chronic and non-communicable diseases (CNCDs) are leading causes of morbidity and mortality % of Indians is estimated to have Type 2 diabetes. One of the associated comorbidity associated with type 2 diabetes is depression. This comorbidity has been estimated from 11% to 71% of individuals with diabetes, depending on the population studied and the diagnostic method used. As compared to non-diabetic patients with diabetes mellitus (DM) are reported to be about 1.4-3 times as likely to suffer from comorbid depression. It was found that association between diabetes and depression is bidirectional, and depression being a risk factor for the development of DM seems to be stronger. Poor diabetes control is probably stressful enough to induce or worsen depressive symptoms. Depression is also associated with physiological abnormalities, including activation of the hypothalamic-pituitary-adrenal axis, sympathoadrenal system, and pro-inflammatory cytokines, which can induce insulin resistance and contribute to diabetes risk.

MATERIAL AND METHODS:  Of the 204 patients only 184 were willing to participate in the study other 20 patients denied to give the written consent and were excluded from the study. All 184 participants were interviewed which involved a questionnaire that collected data on demographic characteristics and depression symptoms. Socioeconomic status was assessed. Depression among the study population was screened by Patient Health Questionnaire (PHQ)-12.We used the 10-item Harvard Department of Psychiatry scale (HANDS) to assess symptoms of major depression over the previous two weeks. Diabetes self-management was assessed. Questions were asked about diet, exercise, self-monitoring of blood glucose (SMBG), foot care, and medication adherence.

RESULTS: Of the total 184 participants 81 (44.02%) were female and 103(55.98%) were male. Mean HANDS score was 6.1±5.7. participants whose education was less than high school were 28 (15.21%), from ?High school to graduation,  121 (65.76%), post-graduation 35 (19.02%). There were 51 (27.72%) patients on insulin and 133 (72.28%) were not taking insulin and were on oral medications.72 (39.13%) were following their diet strictly while 112 (60.87%) were not following the diet. 59 (32.07%) were doing regular exercise while 125 (67.93%) were not doing the exercise or were irregular. Glucose monitoring was done by 96 (52.17%) while 135 (73.37%) were not monitoring their glucose levels. There were 49 (26.63%) who were consuming high fat food while 135 (73.37%) were restricting themselves from the fatty foods. Overall 89 (48.37 %) study participants were suffering from the depression of which 50 (27.17%) were suffering from moderate and 39 (21.20%) suffering from severe depression. Of the total 103 male 44 (42.72%) were suffering from the depression of which 26 (25.24%) were suffering from moderate and 18(17.48%) suffering from severe depression. Of the total 81 females 45 (55.56%) were suffering from the depression of which 24 (29.63%) were suffering from moderate and 39 (21.20%) suffering from severe depression.

CONCLUSION:  There is a strong association between depression and incidence of type 2 diabetes. Incidence of depression was high in females with T2DM as compared to males. Self-care management is a need of hour to control T2DM and thereby control the depression.