Prevalence of Depression among Patients of Type 2 Diabetes Mellitus without Overt Complications and Its Association with Glycemic Control in a Tertiary Care Center in India – A Cross-sectional Study

Abstract

Abstract Background: The prevalence of type 2 diabetes is on the rise worldwide posing a serious threat to public health. In India, it has increased from 3.3% to 19% in urban and 2.4% to 15% in rural areas from 1972 to 2019. Depression is a major contributor to disability-adjusted life years (DALYs) and common comorbidity in diabetic patients. Studies show a bidirectional relationship between depression and diabetes. However, there is a dearth of evidence on the relationship between depressive symptoms and diabetes mellitus. Aim: This study aims to estimate the occurrence of depression in type 2 diabetic patients and to find the association between depression and glycemic control in a tertiary care center in Tamil Nadu, India. Materials and Methods: A cross-sectional study was done among type 2 diabetes mellitus patients of 18–65 years of age. Hemoglobin A1C levels were collected, and the Patient Health Questionnaire-9 (PHQ-9) was administered for screening depression. If PHQ ≥10, the Mini-international Neuropsychiatric Interview (MINI) was done to confirm the diagnosis of depression. The severity was assessed using the Hamilton Depression Rating Scale, and the Diabetes Self-Management Questionnaire was used to assess their self-management behaviors. Results: One hundred and fourteen patients (male = 36, female = 78) were screened for depression, and the diagnosis was confirmed with MINI. Twenty-six patients scored ≥10 scores, of which 8 (7%) met the criteria for moderate depression and 18 (15.8%) for mild depression. Eighty-eight (77.2%) had no depression. The characteristics significantly associated with depression were female gender, poor glycemic control, and systemic hypertension. Conclusion: There are clear evidence in the literature for an increased prevalence of depression in diabetic patients resulting in poorer prognosis. This study demonstrated the association of poor glycemic control with depression. Early diagnosis and multidisciplinary treatment approach addressing both disorders would help improve the global health burden by reducing mortality and DALYs.