Diabetes and depression: Impact of depression on self-care among patients with type 2 diabetes

Abstract

Background: Diabetes is one of the many chronic medical conditions, which is adversely affected by comorbid depression. Research so far suggests an association between clinically significant levels of depression and a range of poorer self-care behaviors such as nonadherence to diet, exercise, and prescribed medications. Objective: (1) To study the prevalence of depression among type 2 diabetic patients; (2) to study the impact of depression on self-care among type 2 diabetic patients. Materials and Methods: A hospital-based cross-sectional study carried out in Urban Health Center, Raichur, Karnataka, India. Totally, 166 patients with established type 2 diabetes mellitus attending the Urban Health Center were interviewed using a predesigned questionnaire based on Summary of Diabetes Self-Care Activities and Patient Health Questionnaire to assess depression. Data were entered in Microsoft Excel and analyzed using Epi Info 7. Results: The mean age of the study subjects was 54.8 years, and the mean duration of diabetes was 7.5 years. Only 18.7% of diabetic patients had done HbA1c test; 77.7% of diabetics were on oral hypoglycemic agents. Depression was found in 28.3% of participants. Nonadherence to treatment, smoking, and decreased physical activity was significantly associated to having depression (P < 0.05). Conclusion: This study showed high prevalence of depression in patients with type 2 diabetes mellitus. Physicians caring diabetic patients must recognize and manage comorbid depression. Abstract 3.4 million people died from complications of diabetes and 80% of these deaths occur in low-and middle-income countries. By the year 2030, diabetes is expected to become the seventh leading cause of death in the world. Type 2 diabetes accounts for 90% of the all the diabetes worldwide and can be prevented. [1] Self-care is the cornerstone of diabetes management. Healthy diet, physical activity, and adherence to medical regimens can slow the disease progression and reduce the morbidity and mortality associated with diabetic complications. [2] Another condition that has high prevalence worldwide is depression. Patients with Type 2 Diabetes Mellitus experience depression twice higher than the general population, and diabetic patients with depression show greater difficulty with self-care. [2,3] The presence of depression in diabetic