Background:
To assess the association of depression with glycemic control and compliance to self-care activities in adult patients with Type II Diabetes Mellitus
Methods:
A cross-sectional study at a tertiary care hospital in Karachi on consecutive patients attending endocrinology clinic at least after two visits and without psychiatric/medical co-morbid illnesses or treatments were interviewed. Demographic and clinical characteristics were obtained through interviews and medical records. Hospital Anxiety Depression Scale (HADS) used to measure depression.Associations of depressed status (HADS value greater than or equal to 8) with poor glycemic control (Hemoglobin A1c level greater than or equal to 7%), correlation of HADS score with HbA1c values and compliance to self care activities were assessed by logistic regression analyses.
Results:
A total of 286 patients participated with male-female ratio of 1.2:1. Mean age was 52 years and average duration of diabetes was 7-8 years. Depressed patients were more likely to be female, have a family history of diabetes (adjusted odds ratio [OR]=2.78; 95% confidence interval [95%CI]=1.92-4.01) and poor glycemic control (OR=5.75; 95%CI=4.13-8.00) than non-depressed patients. Depression was also associated with lower compliance to self-care activities such as taking dose on time (OR=0.30; 95%CI=0.20-0.44), dietary restrictions (OR=0.44; 95%CI=0.33-0.58) and foot care (OR=0.40; 95%CI=0.27-0.58).
Conclusions:
Adult patients with Type 2 Diabetes who have depression are more likely to have poor glycemic control, diabetes-related complications and lower compliance to self-care activities.