Prevalence of Depression among Patients with Type 2 Diabetes Mellitus and its factors affecting the Glycemic control at a Tertiary care Hospital – A Cross-Sectional Study

Abstract

Background: Depression in Diabetic patients is a significant issue that should be addressed since it can affect both physical and mental health of an individual, Constant monitoring of blood sugar levels, adhering to medications and following a strict diet can put an immense burden on the individual, which worsen his mental and eventually affects his diabetic control in several ways. Nearly every 30% of a Diabetic person tends go under depression, which is often remain undiagnosed, it is important for a person with diabetes to have a strong supportive system. Objectives: To assess the association between depression severity and various demographic, clinical, and behavioural factors in patients with type 2 diabetes. Methods: A cross-sectional study was conducted among 100 diabetic patients at Bangalore Baptist Hospital. Depression levels were assessed using the Patient Health Questionnaire (PHQ-9). The medication adherence of the participants was assessed using Morisky Medication Adherence Scale (MMAS-8) and Participants were stratified based on demographic and clinical variables, and statistical significance was evaluated using chi-square tests. Results: Among the 100 participants, 39% exhibited moderate to severe depression (PHQ > 9). Depression was significantly more prevalent among males (45.5%) than females (25.7%) (p = 0.04), and among participants with a monthly income below ₹20,000 (66.7%) compared to higher earners (p = 0.001). Daily wage workers (66.7%) and rural residents (62.0%) were also significantly more affected (p = 0.004 and p = 0.002, respectively). Single, widowed, or divorced individuals had a higher prevalence of depression (60%) compared to married individuals (p = 0.03). Clinical factors such as diabetes duration >5 years (46.5%; p = 0.01), poor glycemic control (HbA1C > 8.0%; 56.5%, p = 0.008), and poor medication adherence (57.7%; p = 0.002) showed strong associations with depression. Additionally, current smoking or alcohol use was significantly linked to higher PHQ scores (54.6%; p = 0.02). These findings highlight key socio-clinical predictors of depression in diabetic patients. Conclusion: Depression in diabetes is significantly influenced by socioeconomic status, clinical severity, and health behaviours. Integrated screening and tailored interventions for mental health should be considered in the management of diabetic patients, especially among high-risk subgroups.

Keywords: Depression, Diabetes Mellitus, PHQ-9, MMAS-8, HbA1C, Socioeconomic factors