High Prevalence of Depressive Symptoms in Patients With Type 1 and Type 2 Diabetes in Developing Countries: Results From the International Diabetes Management Practices Study
Depression is common in people with diabetes but data from developing countries are scarce. We evaluated the prevalence and risk factors for depressive symptoms in patients with diabetes using data from the International Diabetes Management Practices Study (IDMPS).
Research Design and Methods
IDMPS is an ongoing multinational, cross-sectional study investigating quality of care in patients with diabetes in real-world settings. Data from wave 5 (2011), including 21 countries, were analyzed using the Patient Health Questionnaire (PHQ)-9 to evaluate depressive symptoms. Logistic regression analyses were conducted to identify risk factors of depressive symptoms.
Of 9865 patients eligible for analysis, 2280 had type 1 and 7585 had type 2 diabetes (treatment: oral glucose lowering drugs [OGLD] only, n=4729; OGLDs plus insulin, n=1892; insulin only, n=964). Depressive symptoms (PHQ-9 score ≥5) were reported in 30.7% of those with type 1 diabetes. In patients with type 2 diabetes, the respective figures were 29.0% for OGLDs only, 36.6% for OGLDs plus insulin, and 46.7% for insulin only subgroups. Moderate depressive symptoms (PHQ-9 score 10–19) were observed in 8–16% of patients with type 1 or type 2 diabetes. Female sex, complications, and low socioeconomic status were independently associated with depressive symptoms. In type 1 and type 2 diabetes OGLDs only groups, depression was associated with poor glycemic control.
Depressive symptoms are common in patients with diabetes from developing countries calling for routine screening, especially in high-risk groups, to reduce the double burden of diabetes and depression and their negative interaction.