DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20182277

Anxiety and health related quality of life among obese women with type 2 diabetes mellitus

Ranganathan Thirumalai, Vaisnaavi Venkat Shenoy

Abstract


Background: T2DM is often accompanied by a marked reduction in QOL. Psychiatric comorbidity further worsens the QOL and is associated with poor glycaemic control and long term treatment outcomes in T2DM. Obesity may lead to anxiety disorders and is often associated with T2DM. Women in the general population are known to suffer from psychiatric problems more often than men. The health related QOL in a woman having T2DM and comorbid anxiety disorders is likely to be worse. We therefore analysed the QOL and anxiety symptomatology among obese women with T2DM.

Methods: We conducted a cross-sectional study at the Government General Hospital, Chennai. We recruited 50 age and BMI matched obese women with and without T2DM. We also recruited 50 each of diabetic and non-diabetic non-obese women. We used the WHO QOL BREF to assess the QOL, HAM A to quantify anxiety and HAM D to assess depression.

Results: A 71.5% of our patients experienced anxiety symptoms with scores on HAM A indicating mild to moderate levels of anxiety disorder. Obese patients irrespective of their glycaemic status had significantly higher levels of anxiety compared to our non-obese subjects. All our obese patients with T2DM scored statistically significant lowest means across all subdomains on the WHO QOL BREF scale. Obese subjects who had diabetes for >10 years were found to have severe anxiety disorder. The odds ratio that an obese woman would suffer from psychiatric comorbidity was found to be 10.211 (odds ratio = 10.211; 95% C.I. 2.963-35.185).

Conclusions: Anxiety disorders are common in obese women having T2DM. They also had decreased physical health, social relation and psychological domain scores. Having diabetes mellitus for >10 years predicted anxiety symptoms among obese subjects. We suggest early diagnosis and prompt treatment of anxiety disorders in obese women with T2DM as part of their routine primary health care.


Keywords


Anxiety disorders, QOL, Obese women, T2DM

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References


Chan JC, Malik V, Jia W, Kadowaki T, Yajnik CS, Yoon KH, et al. Diabetes in Asia: epidemiology, risk factors, and pathophysiology. JAMA. 2009;301(20):2129-40.

Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry. 2005;62:593-602.

Lustman PJ, Griffith LS, Clouse RE, Cryer PE. Psychiatric illness in diabetes mellitus. Relationship to symptoms and glucose control. J Nervous and Mental Disease. 1986;174:736-42.

Almawi W, Tamim H, Al-Sayed N, Arekat MR, Al-Khateeb GM, Baqer A, et al. Association of comorbid depression, anxiety and stress disorders with type 2 diabetes in Bahrain, a country with a very high prevalence of type 2 diabetes. J Endocrinol Invest. 2008;31:1020-1024.

Mosaku K, Kolawole B, Mume C, Ikem R: Depression, anxiety and quality of life among diabetic patients: a comparative study. J Natl Med Assoc. 2008;100:73-8.

Van Hout GCM, van Oudheusden I, van Heck GL. Psychological profile of the morbidly obese. Obes Surg. 2004;14:579-88.

Carr D, Friedman MA. Is obesity stigmatizing? Body weight, perceived discrimination, and psychological well-being in the United States. J Health Soc Behav. 2005;46:244-59.

Torres SJ, Nowson CA. Relationship between stress, eating behavior, and obesity. Nutrition. 2007;23:887-94.

Khuwaja AK, Lalani S, Dhanani R, Azam IS, Rafique G, White F. Anxiety and depression among outpatients with type 2 diabetes: A multi-centre study of prevalence and associated factors. Diabetol Metab Syndr. 2010;2:72.

Lype T, Shaji SK, Balakrishnan A, Charles D, Varghese A, Antony TP: Cognition in type 2 diabetes: association with vascular risk factors, complications of diabetes and depression. Ann Indian Acad Neurol. 2009;12:25-7.

Shiva raj Mishra, abishek sharma, parash mani Bhandari, shristi bhochhibhoya, kiran thapa: depression and health-related quality of life among patients with type 2 diabetes mellitus: a cross-sectional study in Nepal. PLoS One. 2015;10(11):e0141385.

Lloyd CE, Dyer PH, Barnett AH. Prevalence of symptoms of depression and anxiety in a diabetes clinic population. Diabet Med. 2000;17(3):198-202.

Pibernikā€Okanovic M, Peros K, Szabo S, Begic D, Metelko Z. Depression in Croatian Type 2 diabetic patients: prevalence and risk factors. A Croatian survey from the European Depression in Diabetes (EDID) Research Consortium. Diabetic medicine. 2005 Jul 1;22(7):942-5.

Wang W, Shi L, Wang K. Assessment of quality of life in patients with diabetes mellitus and impaired glucose tolerance. Zhonghua yu fang yi xue za zhi [Chinese J preventive medicine]. 2001 Jan;35(1):26-9.

Rubin RR, Peyrot M. Quality of life and diabetes. Diabetes Metab Res Rev. 1999;15(3):205-18.

Shrestha SS, Shakya R, Karmacharya BM, Thapa P. Medication adherence to oral hypoglycemic agents among type II diabetic patients and their clinical outcomes with special reference to fasting blood glucose and glycosylated hemoglobin levels. Kathmandu Univ Med J (KUMJ). 2013;11(43):226-32.

DiMatteo MR, Lepper HS, Croghan TW. Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Archives of internal medicine. 2000;160(14):2101-7.

Lustman PJ, Anderson RJ, Freedland KE, de Groot M, Carney RM, Clouse RE. Depression and poor glycemic control: a meta-analytic review of the literature. Diabetes Care. 2000;23(7):934-42.