Bahety Prerna, Agarwal Gunjan, Khandelwal Deepak, Dutta Deep, Kalra Sanjay, Taparia Pankaj, Singhal Vikas
Department of Family Medicine, Maharaja Agrasen Hospital, New Delhi, India.
Department of Medicine, Maharaja Agrasen Hospital, New Delhi, India.
Indian J Endocrinol Metab. 2017 Jul-Aug;21(4):564-569. doi: 10.4103/ijem.IJEM_123_17.
Globally, depression has been linked to Type-2 diabetes mellitus (T2DM). However, similar data from India are scant. This study evaluated the occurrence and predictors of depression and health-related quality of life (QOL) in patients with T2DM as compared to healthy controls.
One hundred adults with T2DM without prior diagnosis of depression and 100 matched controls were evaluated. Depression was assessed using Patient Health Questionnaire-9. World Health Organization QOL Brief (WHO-QOL-BREF) was used to assess QOL. Demography, anthropometry, biochemical parameters of diabetes control, and microvascular and macrovascular complications in patients were recorded.
Depression was significantly more common in T2DM (63%) as compared to controls (48%) (odds ratio [OR] - 1.84 [1.04, 3.24]; = 0.03). In T2DM, depression was higher in patients with disease duration >5 years (OR = 2.66; = 0.02), glycated hemoglobin >7% (OR = 3.45; = 0.004), retinopathy (OR - 3.56; = 0.03), and nephropathy (OR - 4.11; = 0.07). Occurrence of depression was significantly higher among the patients with macrovascular complications, namely, coronary artery disease (17.4%; = 0.000006), cerebrovascular disease (14.2%; = 0.0006), and peripheral vascular disease (7.9%; = 0.05). Insulin users had higher depression as compared to patients using only oral antihyperglycemic medications ( = 0.034). Patient with depression had significantly low QOL. The WHO-QOL for all the domains was significantly lower in T2DM with microvascular and macrovascular complications, as compared to those without.
Indian T2DM had higher prevalence of depression and lower QOL as compared to controls, which was associated with poor glycemic control and higher end-organ damage. Public health measures are required to create more awareness for managing depression in diabetes.
在全球范围内，抑郁症与2型糖尿病（T2DM）相关。然而，来自印度的类似数据却很少。本研究评估了T2DM患者与健康对照者相比抑郁症的发生率、预测因素以及健康相关生活质量（QOL）。
对100名未曾诊断出抑郁症的成年T2DM患者和100名匹配的对照者进行了评估。使用患者健康问卷-9评估抑郁症。采用世界卫生组织生活质量简表（WHO-QOL-BREF）评估生活质量。记录患者的人口统计学、人体测量学、糖尿病控制的生化参数以及微血管和大血管并发症情况。
与对照组（48%）相比，抑郁症在T2DM患者中更为常见（63%）（比值比[OR] - 1.84[1.04, 3.24]；P = 0.03）。在T2DM患者中，病程>5年（OR = 2.66；P = 0.02）、糖化血红蛋白>7%（OR = 3.45；P = 0.004）、视网膜病变（OR - 3.56；P = 0.03）和肾病（OR - 4.11；P = 0.07）的患者抑郁症发生率更高。在患有大血管并发症的患者中，即冠状动脉疾病（17.4%；P = 0.000006）、脑血管疾病（14.2%；P = 0.0006）和外周血管疾病（7.9%；P = 0.05），抑郁症的发生率显著更高。与仅使用口服降糖药物的患者相比，使用胰岛素的患者抑郁症发生率更高（P = 0.034）。抑郁症患者的生活质量显著较低。与无微血管和大血管并发症的T2DM患者相比，伴有这些并发症的患者在WHO-QOL所有领域的得分均显著更低。
与对照组相比，印度T2DM患者抑郁症患病率更高，生活质量更低，这与血糖控制不佳和更高的终末器官损害有关。需要采取公共卫生措施以提高对糖尿病患者抑郁症管理的认识。
