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. 2017 Jul-Aug;21(4):564-569.
doi: 10.4103/ijem.IJEM_123_17.

Occurrence and Predictors of Depression and Poor Quality of Life among Patients with Type-2 Diabetes: A Northern India Perspective

Prerna Bahety  1 , Gunjan Agarwal  2 , Deepak Khandelwal  3 , Deep Dutta  4 , Sanjay Kalra  5 , Pankaj Taparia  6 , Vikas Singhal  7
Affiliations

Occurrence and Predictors of Depression and Poor Quality of Life among Patients with Type-2 Diabetes: A Northern India Perspective

Prerna Bahety et al. Indian J Endocrinol Metab. 2017 Jul-Aug.

Abstract

Background and aims: Globally, depression has been linked to Type-2 diabetes mellitus (T2DM). However, similar data from India are scant. This study evaluated the occurrence and predictors of depression and health-related quality of life (QOL) in patients with T2DM as compared to healthy controls.

Materials and methods: One hundred adults with T2DM without prior diagnosis of depression and 100 matched controls were evaluated. Depression was assessed using Patient Health Questionnaire-9. World Health Organization QOL Brief (WHO-QOL-BREF) was used to assess QOL. Demography, anthropometry, biochemical parameters of diabetes control, and microvascular and macrovascular complications in patients were recorded.

Results: Depression was significantly more common in T2DM (63%) as compared to controls (48%) (odds ratio [OR] - 1.84 [1.04, 3.24]; P = 0.03). In T2DM, depression was higher in patients with disease duration >5 years (OR = 2.66; P = 0.02), glycated hemoglobin >7% (OR = 3.45; P = 0.004), retinopathy (OR - 3.56; P = 0.03), and nephropathy (OR - 4.11; P = 0.07). Occurrence of depression was significantly higher among the patients with macrovascular complications, namely, coronary artery disease (17.4%; P = 0.000006), cerebrovascular disease (14.2%; P = 0.0006), and peripheral vascular disease (7.9%; P = 0.05). Insulin users had higher depression as compared to patients using only oral antihyperglycemic medications (P = 0.034). Patient with depression had significantly low QOL. The WHO-QOL for all the domains was significantly lower in T2DM with microvascular and macrovascular complications, as compared to those without.

Conclusion: Indian T2DM had higher prevalence of depression and lower QOL as compared to controls, which was associated with poor glycemic control and higher end-organ damage. Public health measures are required to create more awareness for managing depression in diabetes.

Keywords: Depression; diabetes; diabetes complications; glycemic control; quality of life.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
the risk of depression was 1.84 times among the individuals with Type 2 diabetes mellitus (cases) as compared to the controls (Odds ratio – 1.84 [1.04, 3.24]; P = 0.03)
Figure 2
Figure 2
Distribution of various grades of depression among Type 2 diabetes mellitus individuals (cases) and healthy controls
Figure 3
Figure 3
Frequency of depression among subjects with Type 2 diabetes mellitus with disease duration ≥5 years as compared to those with disease duration <5 years
Figure 4
Figure 4
Frequency of depression among Type 2 diabetes mellitus individuals with poor glycemic control (glycated hemoglobin >7) in comparison with individuals with fair glycemic control (glycated hemoglobin ≤7)
Figure 5
Figure 5
World Health Organization quality of life score for all the domains in Type 2 diabetes mellitus individuals with any chronic micro/macro-vascular complications in comparison with individuals without any of these complications. Statistically, significant for all domains, except domain 4
See this image and copyright information in PMC

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