Introduction
Depression and distress in diabetes is associated with greater morbidity, mortality and healthcare costs. This study explores factors associated with depression and distress in patients with type 2 diabetes.
Methods
Data were analysed from the Australian National Diabetes Audit (ANDA) including 2552 adult patients with type 2 diabetes from 56 diabetes centres across Australia during the 1-month survey period in May/June 2016. Pre-specified demographic and clinical variables were obtained. The Brief Case find for Depression (BCD) and Diabetes Distress Score 17 (DDS17) were administered to screen for likely depression and diabetes-related distress, respectively. Logistic regression was used to examine factors associated with depression and distress.
Results
Mean age of participants was 62.7±12.7 years (mean±SD) and diabetes duration was 12±10 years. Mean HbA1c was 8.3±1.9%. Thirty percent of patients had a BCD score suggesting likely depression and 20% of patients had a DDS 17 score suggesting diabetes distress. Of patients with likely depression, only 35% were on antidepressant medication, 19% were undergoing counselling, and 12% had both. Factors associated with depression on BCD screening were smoking, low medication adherence, lower self-health rating and higher diabetes distress score (all p<0.02 in models adjusting for antidepressant use, age, gender, physical activity and blood glucose monitoring). Factors associated with distress on DDS17 screening were female gender, insulin use, difficulty following the recommended diet, lower self-health rating and depression (all p≤0.03) in models adjusting for antidepressant use, age, physical activity and blood glucose monitoring (Table 1).
Conclusion
Many patients with type 2 diabetes experience depression and distress with a significant proportion remaining untreated. This emphasises the importance of addressing emotional and psychological health in people with diabetes and highlights the need for longitudinal data to confirm the determinants of depression and diabetes distress in type 2 diabetes.