DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20160544

Association of major depression with blood pressure and vascular complications of type 2 diabetes mellitus

Akash Rajender, Deepa C., Krishna Kanwal, R. S. Chaudhri, Gaurav Rajender, Priyanka Choudhary

Abstract


Background: The WHO estimates the diabetic population to increase to 366 million by 2030 worldwide, with maximum 79.4 million Indians. Depression is an undiagnosed co-morbidity leading to significant disability, non-compliance and postulated to cause poorer glycemic control leading to early disease complications. We aimed to detect depression and study its correlation with vascular complications among type 2 diabetes mellitus (T2DM) patients.

Methods: In an observational study, 312 randomly selected T2DM patients were evaluated at tertiary care center in Northern India. Socio-demographic, clinical and laboratory data was collected. Montgomery Asberg depression rating scale (MADRS) was used to detect depression. Groups with and without major depression were compared for various diabetes variables. Statistical analysis was carried out using the SPSS version 14.0.

Results: One third T2DM patients (32.05%) suffered from major depression. Depression was significantly associated with diabetic patients having cardiac (p 0.01), ophthalmic (p 0.04), nephropathy (p 0.01), cerebrovascular (p 0.001) complications and diabetic foot (p 0.04). However, depression showed no significant association with systolic blood pressure, neuropathic and infectious complications.

Conclusions: Identification of depression and its appropriate management may go a long way in delaying diabetic vascular complications by improving treatment adherence and subsequently glycemic control.

 


Keywords


Depression, Diabetes, Complications, Blood pressure

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References


Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes care. 2004;27(5):1047-53.

Egede LE, Ellis C. Diabetes and depression: global perspectives. Diabetes research and clinical practice. 2010;87(3):302-12.

Balhara YP, Sagar R. Correlates of anxiety and depression among patients with type 2 diabetes mellitus. Indian journal of endocrinology and metabolism. 2011;15(Suppl 1):S50-4.

Wulsin LR, Singal BM. Do depressive symptoms increase the risk for the onset of coronary disease? A systematic quantitative review. Psychosom Med. 2003;65:201-10.

Nicholson A, Kuper H, Hemingway H. Depression as an aetiologic and prognostic factor in coronary heart disease: A meta-analysis of 6362 events among 146 538 participants in 54 observational studies. Eur Heart J. 2006;27:2763-74.

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. Arch Intern Med. 2000;160:2101-7.

Lin EH, Katon W, Von Korff M, Rutter C, Simon GE, Oliver M, et al. Relationship of depression and diabetes self-care, medication adherence, and preventive care. Diabetes Care. 2004;27:2154-60.

Raval A, Dhanaraj E, Bhansali A, Grover S, Tiwari P. Prevalence and determinants of depression in type 2 diabetes patients in a tertiary care centre. The Indian journal of medical research. 2010;132:195- 200.

Agarwal RP, Ranka M, Beniwal R, Sharma S, Purohit VP, Kochar DK, et al. Prevalence of Micro and Macro vascular complications in Type 2 Diabetes and their risk factors. International Journal of Diabetes Developing Countries. 2004;24:11-6.

Guruprasad, Niranjan MR, Ashwin S. A study of association of depressive symptoms among the type 2 diabetic outpatients presenting to a tertiary care hospital. Indian Journal of Psychological Medicine. 2012;34(1):30-3.

Rahman M, Rahman MA, Flora MS, Rakibuz-Zaman M. Depression and associated factors in diabetic patients attending an urban hospital of Bangladesh. Int J Collabor at Res Intern Med Public Health. 2011;3:65-76.

Nasser J, Habib F, Hasan M, Khalil N. Prevalence of depression among people with diabetes attending diabetes clinics at primary health settings. Bahrain Med Bull. 2009;31:1-7.

Anderson RJ, Freedland KE, ClouseRE, Lustman PJ. The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes care. 2001;24(6):1069-78.

Poongothai S, Pradeepa R, Ganesan A, Mohan V. Prevalence of depression in a large urban South Indian population - The Chennai urban rural epidemiology study (CURES-70). PloS One. 2009;4:E7185.

Kiran N, Kohrt BA, Flora MS, Thapa N, Mumu SJ, Pathak R, et al. Prevalence of depression and associated risk factors among persons with type-2 diabetes mellitus without a prior psychiatric history: across sectional study in clinical settings in urban Nepal. BMC Psychiatry. 2013;13:309.

Aravind S, Prasanna Kumar KM, Sadikot SM, Nigam A, Bajaj S, Zargar AH, et al. Chronic complications in newly diagnosed patients with type 2 diabetes mellitus in India. Indian J Endocrinol Metab. 2014;18(3):355-60.

UKPDS study group, UK Prospective Diabetes study XII: Differences between Asian, Afro Caribbean and white Caucasian type 2 diabetic patients at diagnosis of diabetes, UK Prospective Diabetes Study Group. Diabet Med. 1994;11:670.

Stankoviü Z, Jašoviü-Gašiü M, Leþiü-Toševski D. Psychological problems in patients with type 2 diabetes: Clinical considerations. Vojnosanit Pregl. 2013;70(12):1138-44.

Nitin J, Unnikrishnan B, Raghavendra Babu YP, Kotian MS, Nelliyanil M. Proportion of depression and its determinants among type 2 diabetes mellitus patients in various tertiary care hospitals in Mangalore city of South India. Indian Journal of Endocrinology and Metabolism. 2013;17(4):681-8.

Téllez-Zenteno JF, Cardiel MH. Risk factors associated with depression in patients with type 2 diabetes mellitus. Arch Med Res. 2002;33:53-60.

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

de Groot M, Jacobson AM, Samson JA, Welch G. Glycemic control and major depression in patients with type 1 and type 2 diabetes mellitus. J Psychosom Res.1999;46:425-35.

Miyaoka Y, Miyaoka H, Motomiya T, Kitamura S, Asai M. Impact of sociodemographic and diabetes related characteristics on depressive state among non-insulin-dependent diabetic patients. Psychiatry Clin Neurosci. 1997;51:203-6

Talbot F, Nouwen A. A review of the relationship between depression and diabetes in adults: is there a link? Diabetes care. 2000;23(10):1556-62.