P26 Association between diabetes and depression in a population with diabetes mellitus 2 treated in a referral center

Abstract

Introduction: The diabetes mellitus 2 (DM2) is considered one of the more demanding psychological chronic diseases. The presence of depressive symptoms is a known comorbidity in patients with diabetes mellitus (1 and 2), being up to three times higher than in the non-diabetic population. Depression is associated with poorer outcomes on metabolic control, adherence to treatment, higher morbidity, and higher health care costs.

Objectives: To know the prevalence of depression and its relationship with metabolic control, chronic complications, sociocultural factors and adherence to treatment.

Methods: A descriptive observational study was conducted during the period May-July 2020. Patients over 15 years old with diagnostic of DM2 who attend the Teaching Care Unit of diabetes in Pasteur Hospital were included. To evaluate depressive symptoms, we applied the Lico Beck Inventory II (BDI-II), which consists of 21 questions and whose score ranges from 0 to 63, with "depression" being equal or greater than 14. It was divided into mild symptoms 14-19, moderate 20-28 and severe 29-63. To evaluate adherence to the treatment, the Morisky Green test was used. This study was conducted in a period of pandemic by COVID-19. The chi -aquare test was used to investigate the association between categorical variables and Spearman’s r to investigate the correlation between quantitative variables. The comparison of quantitative variables in two groups was performed using the Mann Whitney test and , when more than two groups were compared, the Kruskal Wallis test. P values lower than 5% were considerer significant.

Results: 71 patients with DM2 were included, 31 were men (43.7%). The average age was 56.9 years. The mean HbA1c was 8.4% ± 2.4. When applying the BDI-II, symptoms of depression were found in 32 patients (45.1%) of the population; 13 patients (18.3%) had a previous diagnosis of depression. No linear correlation was found between the Beck score and HbA1c. However, if we group: without depression-mild depression and moderate-severe depression, there is a significant difference in the means of HbA1c (p₌0.028). There were more women than men with depression, without reaching statistical significance. Depression was less frequent among those who are active (20.8%) than among those who are unemployed (57%) (p = 0.003). No association was found between depression and marital status or with the level of education. Association was found between depression symptoms and chronic complications (p₌0.033). Among those who joined the treatment the BDI-II score was significantly lower(p₌0.001).

Conclusions: About half of the population studied associated symptoms of depression. The 59.37% of the population with symptoms of depression lacked a diagnosis prior to the study, which shows an underdiagnosis of depression. These findings point to the importance of early detection and the need for treatment of depressive symptoms in people with diabetes.