Depression and anxiety in patients with type 2 diabetes in Indonesia and Malaysia: do age, diabetes duration, foot ulcers, and prescribed medication play a role?

Abstract

Patients with type 2 diabetes mellitus (T2DM) are susceptible to mental health issues, impacting medication adherence and diabetes control. This study aimed to evaluate factors associated with depression and anxiety among T2DM patients in Indonesia and Malaysia. A cross-sectional study was conducted in Indonesia and Malaysia from October 2022 to April 2023 among T2DM patients. The study utilised an instrument with patient and disease data and three validated tools to assess depression, anxiety, and medication adherence. Statistical analysis, including binary logistic regression, was performed using SPSS® version 28 software. A study of 606 T2DM patients revealed that 56.5% were at risk of depression, while 41.6% were at risk of anxiety. Older patients with T2DM had lower rates of depression (AOR = 0.41, 0.25-0.68) and anxiety than younger patients. Normal-weight patients were less likely to experience depression and anxiety (AOR = 0.44, 0.27-0.72) than overweight patients. Patients without diabetic foot ulcers had a lower risk of depression (AOR = 0.34, 0.21-0.55) and anxiety than those with foot ulcers. Patients with a shorter duration of diabetes had a higher risk of depression (AOR = 3.27, 1.70-6.30) and anxiety than those with a longer duration. Patients on insulin-based regimens had higher rates of depression and anxiety (AOR = 2.28, 1.20-4.30) than those on metformin-based regimens. Nonadherent patients were more likely to experience depression and anxiety (AOR = 4.30, 2.22-8.32) than patients who adhered to their medication. The prevalence of depression and anxiety is concerning and influenced by factors such as age, diabetes duration, the presence of diabetic foot ulcers, and the prescribed medication regimen. Further efforts are necessary to enhance the mental health of T2DM patients and improve management outcomes.