Depression in diabetes: ANDA findings of impact on glycaemic control — ASN Events
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  3. Depression in diabetes: ANDA findings of impact on glycaemic control

Depression in diabetes: ANDA findings of impact on glycaemic control (#286)

Gowri Somarajah 1 2 , Bethany Crinall 1 , Sanjeeva Ranasinha 2 3 , Natalie Wischer 4 , Sophia Zoungas 1 2 3
  1. Monash Diabetes Unit, Monash Health, Clayton, Victoria, Australia
  2. Monash Centre for Health Research and Implementation (MCHRI), Monash University, Clayton, Victoria, Australia
  3. Monash School of Public Health and Preventative Medicine, Clayton, Victoria, Australia
  4. National Association of Diabetes Centres, Sydney, NSW, Australia

Background

The co-occurrence of depression and diabetes has been recognised as an emerging global challenge.1 Depression, reported in roughly 20% of people with diabetes worldwide, may have adverse effects on quality of life and treatment outcomes.2

Objective

To determine the relationship of depression on glycaemic control (HbA1c levels) in patients with type 2 diabetes mellitus (T2DM).

Methodology

Data from the 2014 Australian National Diabetes Audit- Australian Quality Self Management Audit 2014 collection: a cross sectional audit of patients across 38 Australian diabetes centres. All consecutive patients attending the diabetes centres during a one-month period were surveyed using the validated Brief Case Find for Depression tool (a score of 2 or more indicating likely depression). Patients with T2DM were considered in these analyses. Logistic regression models examined factors associated with recording an HbA1c of >8% (64 mmol/mol). Variables that were significant (at an α= 0.05) were included in the final multivariable models.

Results

A total of 1797 patients with T2DM were surveyed. The mean HbA1C for patient with an Hba1c <8% was 6.8% (51mmol/mol) (SD = 0.73, n=955) and for patients with an Hba1c >8%, 9.6% (81mmol/mol) (SD=1.5, n=779). 29% of patients were recorded as having likely depression (38%, 37%, 30% and 18%)in those aged 21-40, 41-60, 61-80 and above 80 years respectively). The odds of recording a HbA1c >8% was significantly higher in those patients with likely depression as compared to those that were not (OR 1.80, 95% CI 1.46 to 2.21). This effect was slightly attenuated but remained significant after adjustment for age, sex, smoking status, duration of diabetes, duration on insulin and adequate glucose monitoring, (Adjusted OR 1.45, 95% CI 1.14 to 1.84). Stratification by age group indicated the effect was greatest in those patients aged 21-40 years as compared to all other age groups.

Conclusion

Suboptimal glycaemic control was associated with likely depression in patients with T2DM. This effect was most pronounced in younger patients. Strategies to identify and treat depression would be beneficial in achieving optimal glycaemic outcomes in patients with T2DM.

  1. 1 Fisher EB, Chan JC, Nan H, Sartorius N, Oldenburg B. Co-occurrence of diabetes and depression: conceptual considerations for an emerging global health challenge. J Affect Disord 2012;142(suppl):S56-66
  2. 2 Snoek FJ, Bremmer MA, Hermanns Norbert. Constructs of depression and distress in diabetes: time for an appraisal. Lancet Diabetes Endocrinology 2015;3:450-60