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The Epidemiology of Depression and Diabetes Distress in Type 2 Diabetes in Kuwait.

ABSTRACT: This study is aimed at describing the prevalence of and risk factors for depression and diabetes distress in people with type 2 diabetes and whether depression and distress are independently associated with worse biomedical outcomes. The study was of cross-sectional design. The setting was the Dasman Diabetes Institute, Kuwait. The Patient Health Questionnaire-9 (PHQ-9) was used to measure the prevalence of depression, defined as a score ? 10 (depression caseness). The Problem Areas in Diabetes (PAID) was used to measure diabetes-related distress. Data on biomedical outcomes, lifestyle factors, and sociodemographic information were collected. The prevalence of depression and diabetes distress caseness was 29% and 14%, respectively. Depression caseness patients were more likely to be female (60%; p = 0.001), have Kuwaiti nationality (68%, p = 0.121), were on insulin (67%, p = 0.001), have higher body mass index (p = 0.047), were less physically active (78%; p = 0.034), have a higher PAID score (p < 0.001), and have hypertension (74%, p = 0.047). After adjustment of sociodemographics (age, gender, and marital status) and body mass index, the prevalence of depression was associated with higher HbA1c (B = 0.04, 95% confidence interval 0.01 to 0.60), while diabetes distress had a weak association with HbA1c (B = 0.13, 95% confidence interval 0.04 to 0.22). In conclusion, people with type 2 diabetes in Kuwait have a high prevalence of depression but lower diabetes distress and this was associated with worse glycaemic control.

SUBMITTER: Al-Ozairi E

PROVIDER: S-EPMC7288194 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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The Epidemiology of Depression and Diabetes Distress in Type 2 Diabetes in Kuwait.

Al-Ozairi Ebaa E Al Ozairi Abdulla A Blythe Clare C Taghadom Etab E Ismail Khalida K

Journal of diabetes research 20200601

This study is aimed at describing the prevalence of and risk factors for depression and diabetes distress in people with type 2 diabetes and whether depression and distress are independently associated with worse biomedical outcomes. The study was of cross-sectional design. The setting was the Dasman Diabetes Institute, Kuwait. The Patient Health Questionnaire-9 (PHQ-9) was used to measure the prevalence of depression, defined as a score ≥ 10 (depression caseness). The Problem Areas in Diabetes ...[more]

PMID: 32566681

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Project description:Purpose: To evaluate metabolic control in patients with type 2 diabetes at Dasman Diabetes Institute (DDI, Kuwait), a specialist diabetes clinic and research center, and to investigate its association with patient demographics and clinical characteristics. Methods: Data from 963 patients with type 2 diabetes were retrospectively collected from the Knowledge Based Health Records maintained at DDI for patients who attended DDI during 2011-2014. The collected data included patient demographics, clinical characteristics, and anti-diabetic medications. Student's t-test was used to evaluate the differences in mean values between poor and good glycemic control groups. Categorical variables were assessed using chi-square analysis with Fisher's exact test for small data sets. Results: The patients' mean age was 53.0 ± 9.5 years with equal number of males and females. Females (34.4 ± 7.2 kg/m2) had a higher mean body mass index than males (32.1 ± 6.4 kg/m2). The mean fasting blood glucose and HbA1c levels were 9.6 ± 3.8 mmol/L and 8.5 ± 1.8%, respectively. Dyslipidemia (46%) and hypertension (40%) were the most common comorbidities, whereas nephropathy (36%) and neuropathy (35%) were the most common diabetic complications. The most commonly used anti-diabetic medication was metformin (55%). Factors significantly associated with poor glycemic control (HbA1c level ≥ 7%) included insulin use; neuropathy or foot ulcers as diabetic complications; and elevated systolic blood pressure and total cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, and fasting blood glucose levels. Factors significantly associated with good glycemic control included metformin use and elevated high-density lipoprotein cholesterol level. The proportion of patients with good glycemic control (HbA1c level < 7%) was 29.5%. A large proportion of the patients with poor glycemic control were only administered monotherapy drugs, and two-thirds of the patients were obese. Further, the American Diabetes Association (ADA) recommendations for blood pressure and LDL cholesterol level were met (62 and 63%, respectively) by follow-up year 4. Conclusion: The therapeutic management of type 2 diabetes in Kuwait is suboptimal. Therapeutic strategies should ensure better adherence to ADA guidelines, evaluate the high obesity rates, and adherence to lifestyle recommendations by patients, and continually promote diabetes education and self-empowerment.

Project description:ObjectivesThe psychological distress of people living with diabetes is increased and associated with poorer glycemic outcomes and self-care. We aimed to examine the frequency of depression, anxiety, and diabetes-related distress (DRD) of individuals with type 2 diabetes (T2D) in primary care (PC) and their comparative associations with clinical, self-care, and socio-demographic characteristics, testing for possible different roles on glycemic control and self-care.MethodsThis is a cross-sectional study of 182 adults with a T2D diagnosis of at least six months, recruited between August 2019-March 2020 and May-October 2020, from an urban PC unit. Participants were screened for symptoms of depression (Patient Health Questionnaire-9 (PHQ-9)), anxiety (Generalized Anxiety Disorder-7 (GAD-7)), and DRD (Diabetes Distress Scale (DDS)). Clinical, self-care, and socio-demographic parameters were recorded.ResultsThe frequency of clinically significant symptoms of depression was 16.6%, (PHQ-9 score ⩾10), anxiety 17.7% (GAD-7 score ⩾10), and DRD 22.6% (DDS score ⩾2). All PHQ-9, GAD-7, and DDS scores intercorrelated, and higher scores were found to be associated with female gender, lower income, and prior diagnosis of depression. Higher PHQ-9 and GAD-7 scores were found to be associated with lower education, more hypoglycemia episodes, more blood glucose self-tests and antidepressant or benzodiazepine use. The retired/housewives scored significantly lower in GAD-7 and DDS compared to the unemployed participants. Higher DDS scores were associated with higher glycated hemoglobin, higher fasting plasma glucose, and insulin use. It was also noted that higher PHQ-9 scores were associated with lower uric acid levels and were significantly higher in the sedentary lifestyle group.ConclusionDRD was associated with poorer glycemic outcomes while depressive symptoms were associated with lower physical activity perhaps sharing different roles for glycemic control and self-care. The psychological burden of individuals with T2D may be considered in PC.

Dataset Information

The Epidemiology of Depression and Diabetes Distress in Type 2 Diabetes in Kuwait.

Publications

The Epidemiology of Depression and Diabetes Distress in Type 2 Diabetes in Kuwait.

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