Document Type



Diabetes/Endocrinology and Metabolism


Background: To assess the associations of depression with glycemic control and compliance to self-care activities in adult Patients with Type 2 Diabetes Mellitus. Methods: This cross-sectional study was conducted at a tertiary-care hospital in Karachi (Aga Khan University Hospital). Equal numbers of depressed and non-depressed Patients were consecutively recruited from the diabetic clinic. Information on demographic and clinical characteristics was collected in face-to-face interviews and from medical records. Hospital Anxiety Depression Scale (HADS) was used to measure depression. Associations of depressed status (HADS >= 8) with poor glycemic control (Hemoglobin A1c level >= 7%) and compliance to self-care activities were assessed by logistic regression analyses. Results: A total of 286 Patients were included in this study with a male-female ratio of 1.2:1. Mean age was 52 years and in 64.7% of them, the duration of diabetes was more than 3 years. Depressed Patients were more likely to be female (adjusted odds ratio [OR] = 1.88, 95% confidence interval [95% CI] = 1.07-3.31), had a family history of diabetes (OR = 2.64, 95% CI = 1.26-5.55), and poor glycemic control (OR = 5.57, 95% CI = 2.88-10.76) compared with non-depressed Patients. Depression was also associated with low compliance to self-care activities such as taking dose as advised (OR = 0.32, 95% CI = 0.14-0.73), dietary restrictions (OR = 0.45, 95% CI = 0.26-0.79) and foot care (OR = 0.38, 95% CI = 0.18-0.83). Conclusions: Adult Patients with Type 2 Diabetes who have depression were more likely to have poor glycemic control and lower compliance to self-care activities, and they might need particular attention during follow-up visits.


BMC Psychiatry