Depression and diabetes: impact of antidepressant medications on glycaemic control.

INTRODUCTION

One of the consistent findings among various studies on diabetes has been the prevalence of depression with or without comorbid anxiety among patients of Diabetes Mellitus. Also, numerous other studies have pointed to the negative bearing of the same on blood sugar levels among patients. However there is a lack of data on the outcome of treatment with anti-depressants on the blood glucose level. Considering the ever increasing population of diabetics in our country and the significant causal relationship established by current literature, this study was undertaken.

AIMS AND OBJECTIVES

To study prevalence of depression and anxiety in patients of Type 2 Diabetes Mellitus with an increase in blood glucose levels. To study the socio-demographic profile and role of stressors in patients of Type 2 Diabetes Mellitus. To study the effects of management of depression and anxiety on blood glucose levels in patients of Type 2 Diabetes Mellitus.

SAMPLE SIZE

100 Consecutive 100 patients diagnosed with Type 2 Diabetes Mellitus(DM) fulfilling the inclusion and exclusion criteria were included in the study. Ethics committee approval was taken for the study.The sociodemographic details of the patients were collected using a specially designed semi-structured proforma. Patients were evaluated for psychiatric disorders using DSM IV TR criteria for diagnosis and Montgomery Asberg Depression Rating Scale (MADRS) and Hamilton Anxiety Rating Scale(HAM-A) were used thereafter to assess the severity of depression and anxiety, respectively. Patients detected with depression and / or anxiety were started on T. Escitalopram (10 mg); keeping the management of DM unchanged. Patients were reviewed after 6 weeks from date of initial assessment and blood glucose levels were repeated. Data thus collected was analysed using SPSS Software.

RESULTS

The prevalence of depression with/without anxiety in the study was 39%. Among depressed patients stressors were found in 84% of patients with social and interpersonal stressors as the more prevalent types. The socio-economic profile showed a female preponderance, lower to middle socioeconomic and educational status and majority were married. 47% of the patients started on T. Escitalopram showed lower fasting and post-lunch blood sugar values on follow up, which was clinically and statistically significant.