Depression and glycaemic control among type 2 diabetes patients: a cross-sectional study in a tertiary healthcare facility in Ghana

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Abstract

Background

Diabetes and depression are both chronic debilitating conditions, and their coexistence has been associated with adverse outcomes. In this study, we investigated the association between glycaemic control and depression in type 2 diabetes (T2DM) patients attending a tertiary healthcare facility in Ghana.

Methodology

In a cross-sectional study design, Patient Health Questionnare-9 (PHQ-9) was used to assess depression in 400 T2DM, aged 30–65 years. Anthropometric characteristics and blood pressure were measured. Venous blood was collected to measure the levels of glycated haemoglobin (HbA1c).

Results

The prevalence of depression was 31.3% among T2DM patients. Female gender, being unmarried, frequent intake of alcohol, previous smoking status and insulin use were associated with increased odds of depression, whereas being educated above basic school level was associated with a decreased odds of depression. In a multivariable logistic regression model, being unmarried and poor glycaemic control were associated with an increase in odds of depression after adjusting for age, gender, and social factors. The association between depression and glycaemic control was attenuated when clinical factors were introduced into the model.

Conclusion

In our study population, we found that depression is common among Ghanaians with T2DM, and not associated with poor glycaemic control in a fully multivariable-adjusted model.

Related collections

Most cited references 35

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Depression and poor glycemic control: a meta-analytic review of the literature.

P Lustman, Paul Carney, Melvin E. Clouse … (2000)

Depression is common among patients with diabetes, but its relationship to glycemic control has not been systematically reviewed. Our objective was to determine whether depression is associated with poor glycemic control. Medline and PsycINFO databases and published reference lists were used to identify studies that measured the association of depression with glycemic control. Meta-analytic procedures were used to convert the findings to a common metric, calculate effect sizes (ESs), and statistically analyze the collective data. A total of 24 studies satisfied the inclusion and exclusion criteria for the meta-analysis. Depression was significantly associated with hyperglycemia (Z = 5.4, P < 0.0001). The standardized ES was in the small-to-moderate range (0.17) and was consistent, as the 95% CI was narrow (0.13-0.21). The ES was similar in studies of either type 1 or type 2 diabetes (ES 0.19 vs. 0.16) and larger when standardized interviews and diagnostic criteria rather than self-report questionnaires were used to assess depression (ES 0.28 vs. 0.15). Depression is associated with hyperglycemia in patients with type 1 or type 2 diabetes. Additional studies are needed to establish the directional nature of this relationship and to determine the effects of depression treatment on glycemic control and the long-term course of diabetes.

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Diabetes and depression: global perspectives.

Leonard Egede, Charles A. Ellis (2010)

Diabetes and depression are highly prevalent conditions and have significant impact on health outcomes. This study reviewed the literature on the prevalence, burden of illness, morbidity, mortality, and cost of comorbid depression in people with diabetes as well as the evidence on effective treatments. Systematic review of the literature on the relationship between diabetes and depression was performed. A comprehensive search of the literature was performed on Medline from 1966 to 2009. Studies that examined the association between diabetes and depression were reviewed. A formal meta-analysis was not performed because of the broad area covered and the heterogeneity of the studies. Instead, a qualitative aggregation of studies was performed. Diabetes and depression are debilitating conditions that are associated with significant morbidity, mortality, and healthcare costs. Coexisting depression in people with diabetes is associated with decreased adherence to treatment, poor metabolic control, higher complication rates, decreased quality of life, increased healthcare use and cost, increased disability and lost productivity, and increased risk of death. The coexistence of diabetes and depression is associated with significant morbidity, mortality, and increased healthcare cost. Coordinated strategies for clinical care are necessary to improve clinical outcomes and reduce the burden of illness.

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Risk factors, prevalence, and treatment of anxiety and depressive disorders in Pakistan: systematic review.

Rachel Jenkins, I Ahmad Mirza (2004)

To assess the available evidence on the prevalence, aetiology, treatment, and prevention of anxiety and depressive disorders in Pakistan. Systematic review of published literature. 20 studies, of which 17 gave prevalence estimates and 11 discussed risk factors. Prevalence of anxiety and depressive disorders, risk factors, effects of treatment. Factors positively associated with anxiety and depressive disorders were female sex, middle age, low level of education, financial difficulty, being a housewife, and relationship problems. Arguments with husbands and relational problems with in-laws were positively associated in 3/11 studies. Those who had close confiding relationships were less likely to have anxiety and depressive disorders. Mean overall prevalence of anxiety and depressive disorders in the community population was 34% (range 29-66% for women and 10-33% for men). There were no rigorously controlled trials of treatments for these disorders. Available evidence suggests a major social cause for anxiety and depressive disorders in Pakistan. This evidence is limited because of methodological problems, so caution must be exercised in generalising this to the whole of the population of Pakistan.

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Author and article information

Contributors

Josephine Akpalu: janduah@yahoo.com

Ernest Yorke: pavlovium@yahoo.com

Joana Ainuson-Quampah: quampah73@gmail.com

Williams Balogun: balogee@yahoo.com

Kwame Yeboah:

ORCID: http://orcid.org/0000-0001-5240-0645

kyeboah@ug.edu.gh , melvinky@gmail.com

Journal

Journal ID (nlm-ta): BMC Psychiatry

Journal ID (iso-abbrev): BMC Psychiatry

Title: BMC Psychiatry

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-244X

Publication date (Electronic): 6 November 2018

Publication date PMC-release: 6 November 2018

Publication date Collection: 2018

Volume: 18

Electronic Location Identifier: 357

Affiliations

[1 ]ISNI 0000 0004 1937 1485, GRID grid.8652.9, Department of Medicine & Therapeutics, School of Medicine & Dentistry, , University of Ghana, ; Accra, Ghana

[2 ]ISNI 0000 0004 1937 1485, GRID grid.8652.9, Department of Dietetics, School of Biomedical and Allied Health Sciences, , University of Ghana, ; Accra, Ghana

[3 ]ISNI 0000 0004 1794 5983, GRID grid.9582.6, College of Medicine, , University of Ibadan, ; Ibadan, Nigeria

[4 ]ISNI 0000 0004 1937 1485, GRID grid.8652.9, Department of Physiology, School of Biomedical and Allied Health Sciences, , University of Ghana, ; Accra, Ghana

Author information

Kwame Yeboah http://orcid.org/0000-0001-5240-0645

Article

Publisher ID: 1933

DOI: 10.1186/s12888-018-1933-2

PMC ID: 6219193

PubMed ID: 30400843

SO-VID: da06a96c-73a3-4ed8-ba86-7b0bec745adc

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.