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. 2024 Oct;61(10):1231-1240.
doi: 10.1007/s00592-024-02275-4. Epub 2024 May 14.

Sex-driven factors associated with anxiety and depression in autoimmune diabetes

Enrico Saudelli  1   2 , Simona Moscatiello  1 , Michele Baldari  1   2 , Claudio Bongiorno  1   2 , Stefano Zucchini  3 , Giulio Maltoni  3 , Alessandro Agostini  2 , Alexandro Paccapelo  4 , Elena Nardi  2 , Danilo Ribichini  1 , Alessia Bruco  1   2 , Valentina Lo Preiato  1 , Gilberto Laffi  1 , Uberto Pagotto  1   2 , Guido Di Dalmazi  5   6
Affiliations

Sex-driven factors associated with anxiety and depression in autoimmune diabetes

Enrico Saudelli et al. Acta Diabetol. 2024 Oct.

Abstract

Aim: To analyze the prevalence of anxiety and depression in a large cohort of adults with autoimmune diabetes, identifying sex-driven associated factors.

Materials and methods: In this cross-sectional study, we enrolled 553 consecutive adults with Type 1 diabetes mellitus or latent autoimmune diabetes in adults who came to the Division of Endocrinology of the S.Orsola-Malpighi Polyclinic, Bologna (Italy), to receive their second dose of SARS-CoV-2 vaccine. We administered the questionnaires: Hospital Anxiety and Depression Scale, Diabetes Distress Scale, Diabetes-related Quality of Life, Diabetes Treatment Satisfaction Questionnaire. We collected clinical and biochemical data and 14 days glucose metrics in patients with sensor use > 70% in a time span of ± 4 months from the questionnaires' administration. We excluded 119 patients from our analyses with missing data (final cohort n = 434: 79% of those enrolled).

Results: Anxiety and depression prevalence was respectively 30.4% and 10.8%. According to the multivariate analysis, higher diabete-related emotional burden, lower treatment satisfaction, but not physician-related distress, were risk factors for anxiety and depression; female sex was associated with anxiety (OR 0.51, 95% 0.31-0.81; p = 0.005); in women, depression was associated with increasing age (males vs. females OR 0.96 per 1 year increase, 95% CI 0.92-1.00; p = 0.036), whilst in men with HbA1c (OR 1.08 per 1 mmol/mol increase, 95% CI 1.03-1.13; p = 0.002).

Conclusion: Nearly 1/3 of patients with autoimmune diabetes suffers from anxiety and 1/10 from depression. These conditions are associated with independent modifiable and non-modifiable characteristics. For depression, these characteristics differ between males and females.

Keywords: Autoimmune diabetes; Continuous glucose monitoring; HADS; Hospital Anxiety and Depression Scale; Type 1 diabetes mellitus.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Summary of the main results on the prevalence of anxiety and depression and their independent risk factors. OR, odds ratio; DTSQ: Diabetes Treatment Satisfaction Questionnaire; DDS: Diabetes Distress Scale; EB: Emotional Burden; RD: Regimen Distress; HbA1c, glycated hemoglobin; M = males
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