Metabolic control and depression in type 1 diabetes mellitus
https://doi.org/10.14341/DM2015247-53
Abstract
The most common mental disorder in patients with diabetes mellitus (DM) is depression (DS). Despite the large number of papers about DS in DM, its prevalence in type 1 DM (T1DM) remains unclear.
Aim.
The aim of this study was to investigate the prevalence of DS in T1DM and its possible association with metabolic control disorders.
Materials and Methods.
The study included 163 patients with T1DM. The patients were aged 18?65 years, and the mean duration of T1DM was 11.18 years (range 4.28?22.33 years). The control group included 75 apparently healthy individuals. The subjects underwent physical examination, and the standard self-report Hospital Anxiety and Depression Scale questionnaire was administered to evaluate the level of anxiety and DS. Psychological counselling was conducted to diagnose DS and its severity. The continuous glucose monitoring system (CGMS) was used to monitor interstitial fluid glucose levels. Statistical analysis was conducted using SPSS Statistics 17.0 and StatSoft Statistica 6.0.
Results.
The prevalence of DS among the patients with T1DM was much higher (approximately two-fold) than the prevalence among the healthy individuals. Female sex and age over 40 years were associated with the presence of DS.
Conclusion.
The development of DS in patients with T1DM is accompanied by poor glycaemic control and increased risk of hypoglycaemic episodes.
Aim.
The aim of this study was to investigate the prevalence of DS in T1DM and its possible association with metabolic control disorders.
Materials and Methods.
The study included 163 patients with T1DM. The patients were aged 18?65 years, and the mean duration of T1DM was 11.18 years (range 4.28?22.33 years). The control group included 75 apparently healthy individuals. The subjects underwent physical examination, and the standard self-report Hospital Anxiety and Depression Scale questionnaire was administered to evaluate the level of anxiety and DS. Psychological counselling was conducted to diagnose DS and its severity. The continuous glucose monitoring system (CGMS) was used to monitor interstitial fluid glucose levels. Statistical analysis was conducted using SPSS Statistics 17.0 and StatSoft Statistica 6.0.
Results.
The prevalence of DS among the patients with T1DM was much higher (approximately two-fold) than the prevalence among the healthy individuals. Female sex and age over 40 years were associated with the presence of DS.
Conclusion.
The development of DS in patients with T1DM is accompanied by poor glycaemic control and increased risk of hypoglycaemic episodes.
Supporting agencies: The Republican Research Centre for Radiation Medicine and Human Ecology, Gomel, Republic of Belarus
About the Authors
Tatiana Vyacheslavovna Mokhort
Belarusian State Medical University, Minsk
Belarus
MD, PhD, Professor, Head of the Department of Endocrinology
Competing Interests: Нет конфликта интересов
Belarus
MD, PhD, Professor, Head of the Department of Endocrinology
Competing Interests: Нет конфликта интересов
Yana Leonidovna Navmenova
Gomel State Medical University
Belarus
MD, PhD, Research assistant, Department of Internal Diseases and Endocrinology №2
Competing Interests: Нет конфликта интересов
Belarus
MD, PhD, Research assistant, Department of Internal Diseases and Endocrinology №2
Competing Interests: Нет конфликта интересов
References
1. Anderson RJ, Freedland KE, Clouse RE, Lustman PJ. The Prevalence of Comorbid Depression in Adults With Diabetes: A meta-analysis. Diabetes care. 2001;24(6):1069-1078. doi: 10.2337/diacare.24.6.1069
2. Дробижев М.Ю. Распространенность психических расстройств в общемедицинской сети и потребность в психофармакотерапии. // Психиатрия и психофармакотерпия. – 2002. - №5 – С.175-180. [Drobizhev MYu. The Prevalence of mental disorders in General medical network and the need for pharmacotherapy. Psychiatry and psychopharmacotherapy. 2002;(5):175-180.]
3. Katon W, Russo J, Lin EHB, et al. Diabetes and Poor Disease Control: is Comorbid Depression Associated with Poor Medication Adherence or Lack of Treatment Intensification? Psychosomatic medicine. 2009;71(9):965-972. doi: 10.1097/PSY.0b013e3181bd8f55
4. Navmenova Y, Mokhort T. The frequency of estimation among patients with diabetes mellitus. Proceedings of the 12th European Congress of Endocrinology; 2010 Apr. 24–28; Prague, Czech Republic: P. 281.
5. Gendelman N, Snell-Bergeon JK, McFann K, et al. Prevalence and Correlates of Depression in Individuals With and Without Type 1 Diabetes. Diabetes care. 2009;32(4):575-579. doi: 10.2337/dc08-1835
6. Lloyd CE, Zgibor J, Wilson RR, et al. Cross-cultural comparisons of anxiety and depression in adults with type 1 diabetes. Diabetes/metabolism research and reviews. 2003;19(5):401-407. doi: 10.1002/dmrr.394
7. Chowdhury S. Depression and diabetes: a risky comorbidity. J Indian Med Assoc. 2004;102(10):554-556. PMid:15887822
8. Al-Amer RM, Sobeh MM, Zayed AA, Al-domi HA. Depression among adults with diabetes in Jordan: risk factors and relationship to blood sugar control. Journal of diabetes and its complications. 2011;25(4):247-252. doi: 10.1016/j.jdiacomp.2011.03.001
9. Kilzieh N, Rastam S, Maziak W, Ward KD. Сomorbidity of depression with chronic diseases: a population-based study in Aleppo, Syria. International journal of psychiatry in medicine. 2008;38(2):169-184. doi: 10.2190/PM.38.2.d
10. Youssef RM. Comprehensive health assessment of senior citizens in Al-Karak governorate, Jordan. East Mediterr Health J. 2005;11(3):334-348.
11. Harris MD. Psychosocial aspects of diabetes with an emphasis on depression. Curr Diab Rep. 2003;3(1):49-55. doi: 10.1007/s11892-003-0053-6
12. Waitzfelder B, Gerzoff RB, Karter AJ, et al. Correlates of depression among people with diabetes: The Translating Research Into Action for Diabetes (TRIAD) study. Primary care diabetes. 2010;4(4):215-222. doi: 10.1016/j.pcd.2010.07.002
13. Al-Amer RM, Sobeh MM, Zayed AA, Al-domi HA. Depression among adults with diabetes in Jordan: risk factors and relationship to blood sugar control. Journal of diabetes and its complications.25(4):247-252. doi: 10.1016/j.jdiacomp.2011.03.001
14. Lustman PJ, Clouse RE. Depression in diabetic patients. Journal of diabetes and its complications. 2005;19(2):113-122. doi: 10.1016/j.jdiacomp.2004.01.002
15. Van Tilburg MA, McCaskill CC, Lane JD, et al. Depressed mood is a factor inglycemic controlin type 1 diabetes. PsychosomMed. 2001;63(4):551-555. doi: 10.1097/00006842-200107000-00005
16. Sacco WP, Bykowski CA. Depression and hemoglobin A1c in type 1 and type 2 diabetes: The role of self-efficacy. Diabetes research and clinical practice. 2010;90(2):141-146. doi: 10.1016/j.diabres.2010.06.026
17. Pouwer F, Geelhoed-Duijvestijn PHLM, Tack CJ, et al. Prevalence of comorbid depression is high in out-patients with Type 1 or Type 2 diabetes mellitus. Results from three out-patient clinics in the Netherlands. Diabetic Medicine. 2010;27(2):217-224. doi: 10.1111/j.1464-5491.2009.02903.x
18. Georgiades A, Zucker N, Friedman KE, et al. Changes indepressive symptoms and glycemic control in diabetes mellitus. Psychosom Med. 2007;69(3):235-241. doi: 10.1097/PSY.0b013e318042588d
19. Mokan M, Mitrakou A, Veneman T, et al. Hypoglycemia unawareness in IDDM. Diabetes Care. 1994;17(12):1397-1403. doi: 10.2337/diacare.17.12.1397
20. Петеркова В.А., Кураева Т.Л., Титович Е.В. Современная инсулинотерапия сахарного диабета 1 типа у детей и подростков. Лечащий врач. – 2003. – №10 – С.50–54. [Peterkova VA, Kuraeva T L, Titovich EV. Modern insulin therapy of diabetes type 1 in children and adolescents. The attending doctor. 2003;(10): 50–54.]
21. Cryer P. Hypoglycaemia: The limiting factor in the glycaemic management of Type I and Type II Diabetes. Diabetologia. 2002;45(7):937-948. doi: 10.1007/s00125-002-0822-9
22. Karter AJ, Parker MM, Moffet HH, et al. Missed appointments and poor glycemic control: an opportunity to identify high-risk diabetic patients. Med Care. 2004;42(2):110-115. doi: 10.1097/01.mlr.0000109023.64650.73
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For citations:
Mokhort T.V., Navmenova Ya.L. Metabolic control and depression in type 1 diabetes mellitus. Diabetes mellitus. 2015;18(2):47-53. (In Russ.) https://doi.org/10.14341/DM2015247-53
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