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Year : 2018 | Volume : 6 | Issue : 1 | Page : 6 - 15  


Original Articles
A Study of Depression and Metabolic Syndrome (Mets) In Patients of Type 2 Diabetes Mellitus (T2DM) At Rural Tertiary Care Hospital

Mundhe Sanjay A1, Birajdar Siddheshwar V2, Chavan Sheshrao S3

1 Assistant Professor, 2 Professor, 3 Associate Professor, Department of General Medicine, Swami Ramanand Tirth Rural Government Medical College, Ambajogai, Maharashtra, India

Corresponding Author:

Email: drsanjaymundhe@gmail.com

Abstract:

Background: Co-morbid depression may occur among diabetic patients, and may be associated with poor outcomes. However, despite large diabetic population, literature of depression in T2DM from India is scare.

Objective: Our aim was to measure the proportion of depression and metabolic syndrome (Mets) in T2DM in rural population and to determine the association of depression with different demographic and clinical parameters.

Methods: This cross‑sectional study was done at the out-patient clinic of rural tertiary care hospital in central India. Cases were eligible patients with T2DM. Depression and Mets were assessed with patient health questionairre‑9 (PHQ‑9) and IDF criteria respectively and their relationship with sociodemographic and clinical profile including complications were analyzed.

Results: Total 300 patients (58.67% females) were evaluated. The proportion of depression and Mets were 25.3%&45.3% respectively. Severe depression (PHQ score ≥15) was present in 13 (17.11%), moderate depression (PHQ score 10-14) in 28 (36.84%), and mild depression(PHQ score 5-9) in 35 (46.05%) of subjects. Depression and Mets were significantly more prevalent in females (33% vs 14.5%) and (53.4% vs. 33.9%) respectively. Patients having comorbid depression and Mets had significantly higher fasting plasma glucose, hypertension, TG, BMI, longer duration of diabetes and lower HDL-C while those with depresion also had significantly higher proportion of pill burden and various complication of T2DM (p<0.05).

Conclusions: Our study demonstrates comparatively lower proportion of depression in T2DM patients from rural population. Variety of demographic and clinical parameters are associated with depression in T2DM and those patients should be routinely evaluated for depression.

Key-words: Depression, Metabolic Syndrome, PHQ‑9, Type 2 Diabetes Mellitus.

Key Messages: In this study, we found a comparatively lower prevalence of depression among patients with T2DM from rural population. Patients having co morbid depression and Mets in T2DM had significantly higher age, female sex, higher fasting plasma glucose, hypertension, higher TG, higher BMI, longer duration of diabetes and lower HDL-C while those with depression also had significantly higher proportion of pill burden and various complication of T2DM. The T2DM and depression are causally related and needs attention from physicians to ensure better treatment outcomes. Patients of T2DM should be universally screened for depression, while special attention should be given to those who have metabolic syndrome and complications of T2DM. More large scale studies are required to determine the mechanisms of different associated factors and to test interventions to decrease the risk of co-morbid depression and their adverse outcomes.





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