Depression in Tunisian type 2 diabetic patients: prevalence and association to glycemic control and to treatment compliance

Abstract

Aim: to study the prevalence of depression in type 2 diabetes and to seek for a relationship between glycemic control and treatment adherence.

Methods: This cross-sectional study was carried out at the outpatient department of the Tunis nutrition institute. A total of 100 diabetic patients followed for Type 2 diabetes were randomly recruited. We used a structured questionnaire to collect patients' socio-demographic, clinical and therapeutic data. The treatment adherence was assessed by using MAS, Glycemic control according to blood glucose and glycated hemoglobin (HbA1c) levels and depression and anxiety by administering a dialectal Arabic validated version of Hospital Anxiety and Depression Scale (HAD). Finaly we also used the modules on mood disorders of the mini international neuropsychiatric interview (MINI).

Results: The prevalence of depression in T2DP was 38% according to the HAD scale with severe forms in 18%. The anxiety prevalence was 31%. However, 18% of T2DP had anxious-depressive co morbidity. According to the MINI, 31% of T2DP had a mood disorder. Dysthymia was noted in 14% of cases, an isolated depressive episode in 6%. Depressed T2DP have a poor glycemic control than those no depressed. Macro-angiopathy, irregular followed-up, poor treatment adherence and unbalanced diet were associated with depression.

Conclusion: The detection of depression related to somatic pathology in particular diabetes, seems essential. As a result, depression treatment may improve the overall prognosis of the associated somatic diseases.