Published date:Dec 31 2020

Journal Title: Sudan Journal of Medical Sciences

Issue title: Sudan JMS: Volume 15 (2020), Issue No. 4

Pages:408 – 417

DOI: 10.18502/sjms.v15i4.8163

Mohamed Osman AbdelazizDepartment of Medicine, Faculty of Medicine & Health Sciences, University of Dongola, Dongola, Sudan

Mohamed Ali AlzainDepartment of Community Medicine, Faculty of Medicine & Health Sciences, University of Dongola, Dongola, Sudan

Mohammed Abdalmageed AbdalkhalegTeaching Assistant, Department of Medicine, Faculty of Medicine & Health Sciences, University of Dongola, Dongola, Sudan

Background: Type 2 diabetes and depression are common diseases with bidirectional associations. Depression in diabetics leads to poor adherence to diet and medication, poor glycemic control, reduced quality of life, and increased diabetes-related healthcare expenditure. This study aimed at evaluating diabetic patients with depression to improve the quality of care delivered. Materials and Methods: An institution-based cross-sectional study was conducted among adult type 2 diabetics at Al-Jemaih Diabetic Center, Dongola, in July–December 2019A standardized pretested questionnaire was used to collect data, and the depression subscale of the Patient Health Questionnaire was used to diagnose depression. Chi-square test and logistic regression were used to analyze the data using the Statistical Package for Social Sciences version 25.0. Results: Out of the 407 participants, 282 (69.3%) were females, and more than half were aged between 40 and 59 years. The prevalence of depression among type 2 diabetic patients was 35.6%, ranging from mild (24.3%) to moderate (7.4%), moderately severe (2.2%), and severe depression (1.7%). The risk factors associated with depression in type 2 diabetes were: combining antidiabetic therapy, long duration of diabetes, family history of psychiatric illness, diabetes-related complications, poor glycemic control, and lack of regular exercise. Conclusion: More than a third of type 2 diabetics have depression. Screening diabetic patients for depression, establishing a psychiatric unit at the diabetic center, and community-based studies are recommended.

Key words: diabetes mellitus, depression, Dongola, Northern State

Huizinga, M. M. and Rothman, R. L. (2006). Addressing the diabetes pandemic: a comprehensive approach. Indian Journal of Medical Research, vol. 124, no. 5, pp. 481–484. Retrieved from https://search.proquest.com/openview/b6814b4ac9d1c29a8fa59e12e6473d10/1?pq-origsite=gscholar&cbl=37533 (accessed August 1, 2020).
[2] IDF. (2019). IDF Atlas 2019 Fact sheet (9th ed.). Retrieved from https://www.diabetesatlas.org/en/resources/ (accessed August 8, 2020).
[3] IDF. (2019). IDF Atlas 2019 Fact sheet: MENA (9th ed.). Retrieved from https://www.idf.org/our-network/regions-members/middle-east-and-north-africa/diabetes-in-mena.html (accessed August 8, 2020).
[4] Elbagir, M., Eltom, M., Elmahadi, E., et al. (1998). A high prevalence of diabetes mellitus and impaired glucose tolerance in the Danagla community in Northern Sudan. Diabetic Medicine, vol. 15, pp. 164–169.
[5] Eltom, M. A., Mohamed, A. H., Elrayah-Eliadarous, H., et al. (2018). Increasing prevalence of type 2 diabetes mellitus and impact of ethnicity in north Sudan. Diabetes Research and Clinical Practice, vol. 136, pp. 93–99. Retrieved from https://doi.org/10.1016/j.diabres.2017.11.034
[6] WHO. (2017). Depression and Other Common Mental Disorders: Global Health Estimates. Geneva: World Health Organization. License: CC BY-NC-SA 3.0 IGO. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/254610/WHO-MSD-MER-2017.2-eng.pdf (accessed on August 8, 2020).
[7] Ritchie, H. and Roser, M. (2019). Mental Health. Retrieved from https://ourworldindata.org/mental-health (accessed on August 01, 2020).
[8] Thour, A., Das, S., Sehrawat, T., et al. (2015). Depression among patients with diabetes mellitus in North India evaluated using patient health questionnaire-9. Indian Journal of Endocrinology and Metabolism, vol. 19, no. 2, pp. 252–255. doi:10.4103/2230-8210.149318
[9] Lustman, P. J. and Clouse, R. E. (2005). Depression in diabetic patients: the relationship between mood and glycemic control. Journal of Diabetic Complications, vol. 19, no. 2, pp. 113–122. Retrieved from https://doi.org/10.1016/j.jdiacomp.2004.01.002
[10] Reddy, P., Philpot, B., Ford, D., et al. (2010). Identification of depression in diabetes: the efficacy of PHQ-9 and HADS-D. British Journal of General Practice, vol. 60, no. 575, pp. e239–e245. Retrieved from https://doi.org/10.3399/bjgp10X502128
[11] van Steenbergen-Weijenburg, K. M., de Vroege, L., Ploeger, R. R., et al. (2010). Validation of the PHQ-9 as a screening instrument for depression in diabetes patients in specialized outpatient clinics. BMC Health Services Research, vol. 10, p. 235. Retrieved from https://doi.org/10.1186/1472-6963-10-235
[12] Kroenke, K., Spitzer, R. L., and Williams, J. B. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine, vol. 16, no. 9, pp. 606–613. Retrieved from https://doi.org/10.1046/j.1525-1497.2001.016009606.x
[13] Mirghani, H. O., Mohammed, O. S., and Saadallah, A. M. (2014). Prevalence of depression among Sudanese patients with type 2 diabetes mellitus. Sudan Journal of Medical Sciences, vol. 9, no. 3, pp. 151–155. Retrieved from https://www.ajol.info/index.php/sjms/article/view/114285
[14] Udedi, M., Muula, A. S., Stewart, R. C., et al. (2019). The validity of the patient health Questionnaire-9 to screen for depression in patients with type-2 diabetes mellitus in non-communicable diseases clinics in Malawi. BMC Psychiatry, vol. 19, p. 81. Retrieved from https://doi.org/10.1186/s12888-019-2062-2
[15] Kroenke, K., Spitzer, R. L., and Williams, J. B. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine, vol. 16, no. 9, pp. 606–613. Retrieved from https://doi.org/10.1046/j.1525-1497.2001.016009606.x
[16] Ismail, M. F. S., Fares, M. M., and Abd-Alrhman, A. G. (2019). Prevalence of depression and predictors of glycemic control among type 2 diabetes mellitus patients at family medicine clinic, Suez Canal University Hospital Egypt. World Family Medicine, vol. 17, no. 2, pp. 4–13. Retrieved from https://pdfs.semanticscholar.org/4173/a0e90cd797877e0205929048e919593c7d2d.pdf
[17] Habtewold, T. D., Radie, Y. T., and Sharew, N. T. (2015). Prevalence of depression among type 2 diabetic outpatients in Black Lion Specialized Hospital, Addis Ababa, Ethiopia. Depression Research and Treatment, article ID 184902. Retrieved from https://doi.org/10.1155/2015/184902
[18] Thour, A., Das, S., Sehrawat, T., et al. (2015). Depression among patients with diabetes mellitus in North India evaluated using patient health questionnaire-9. Indian Journal of Endocrinology and Metabolism, vol. 19, no. 2, pp. 252–255. Retrieved from https://dx.doi.org/10.4103%2F2230-8210.149318
[19] Nagabhirava, G., Umate, M., Nimkar, S., et al. (2017). Depression and anxiety as comorbid disorders in patients with type ii diabetes. International Journal of Medical Science and Public Health, vol. 6, no. 3, pp. 544–548. doi:10.5455/ijmsph.2017.0956304102016
[20] Mendenhall, E., Norris, S. A., Shidhaye, R., et al. (2014). Depression and type 2 diabetes in low- and middle-income countries: a systematic review. Diabetes Research and Clinical Practice, vol. 103, no. 2, pp. 276–285. Retrieved from https://doi.org/10.1016/j.diabres.2014.01.001
[21] Bai, X., Liu, Z., Li, Z., et al. (2018). The association between insulin therapy and depression in patients with type 2 diabetes mellitus: a meta-analysis. BMJ Open, vol. 8, no. 11, p. e020062. Retrieved from http://dx.doi.org/10.1136/bmjopen-2017-020062
[22] Darwish, L., Beroncal, E., Sison, M. V., et al. (2018). Depression in people with type 2 diabetes: current perspectives. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, vol. 11, pp. 333–343. Retrieved from https://dx.doi.org/10.2147%2FDMSO.S106797
[23] Azeze, G. A., Adema, B. G., Adella, G. A., et al. (2020). Factors associated with untreated depression among type 2 diabetic patients at Halaba Kulito Hospital, South Ethiopia: a cross-sectional study. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, vol. 13, pp. 2189–2198. Retrieved from https://dx.doi.org/10.2147%2FDMSO.S255360
[24] Arambwela, M. H., Somasundaram, N. P., Jayasekara, H. B. P. R., et al. (2019). Prevalence of depression and associated risk factors among patients with type 2 diabetes attending the diabetic clinic at the tertiary care hospital in Sri Lanka: a descriptive study. Psychiatry Journal, article ID 7468363. Retrieved from https://doi.org/10.1155/2019/7468363
[25] Lloyed, C. E., Nouwen, A., Sartorious, N., et al. (2018). Prevalence and correlates of depressive disorders in people with Type 2 diabetes: results from the International Prevalence and Treatment of Diabetes and Depression (INTERPRET ‐DD ) study, a collaborative study carried out in 14 countries. Diabetes Medicine. Retrieved from https://doi.org/10.1111/dme.13611
[26] Andreoulakis, E., Hyphantis, T., Kandylis, D., et al. (2012). Depression in diabetes mellitus: a comprehensive review. Hippokratia, vol. 16, no. 3, pp. 205–214.
[27] World Health Organization. (2017). Addressing comorbidity between mental disorders and major noncommunicable diseases. Retrieved from https://www.euro.who.int/en/publications/abstracts/addressing-comorbidity-between-mental-disorders-and-major-noncommunicable-diseases-2017 (accessed on August 07, 2020).
[28] Andreoulakis, E., Hyphantis, T., Kandylis, D., et al. (2012). Depression in diabetes mellitus: a comprehensive review. Hippokratia, vol. 16, no. 3, pp. 205–214. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3738724/pdf/hippokratia-16-205.pdf