Occurrence and Predictors of Depression and Poor Quality of Life among Patients with Type-2 Diabetes: A Northern India Perspective.

BACKGROUND AND AIMS

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.

MATERIALS AND METHODS

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.

RESULTS

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.

CONCLUSION

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.