Frequency of depression among patients with Type-I diabetes in a developing country, Pakistan

Anxiety status in outpatients of Type-2 diabetes mellitus

Objectives

This study intended to determine the frequency of anxiety in outpatients of Type-2 diabetes mellitus (T2DM) and to evaluate its associated characteristics.

Methods

This cross-sectional observational study was accomplished from July 1, 2023, to December 31, 2023, at the Department of Endocrinology at Hayatabad Medical Complex, Peshawar. The study comprised of individuals with T2DM who were at least 18 years of age and of either gender and who presented to the outpatient department for various reasons. The Beck Anxiety Inventory (BAI) was utilized to assess the respondents' level of anxiety.

Results

A total of 306 patients with T2DM were enrolled, of whom, 116 (37.9%) were males and 190 (62.1%) were females. The mean age and HbA1c of the participants were 50.7 ± 11.2 years and 12.02 ± 2.03%. Majority (40.2%) of the participants had moderate anxiety while low anxiety and severe level of anxiety were reported by 30.4% and 29.4% participants, respectively. There was a statistically significant association of anxiety with gender, education, employment, family history, comorbidities, and HbA1c. Educated patients (OR=2.7, 95% CI 1.5 to 5.01 p=0.001), and those with comorbidities (OR= 2.3, 95% CI 0.91 to 5.98, p=0.01) had higher odds for occurrence of anxiety.

Conclusion

Almost 70% of the outpatients of T2DM had moderate to severe anxiety, with most of the clinicodemographic characteristics as potential associated factors. It is crucial for informing clinical practice, enhancing patient care, and promoting better mental health outcomes in this population.

The impact of hypoglycemia on quality of life and related outcomes in children and adolescents with type 1 diabetes: A systematic review

Objective

To conduct a systematic review to examine associations between hypoglycemia and quality of life (QoL) in children and adolescents with type 1 diabetes.

Methods

Four databases (Medline, Cochrane Library, CINAHL, PsycINFO) were searched systematically in November 2019 and searches were updated in September 2021. Studies were eligible if they included children and/or adolescents with type 1 diabetes, reported on the association between hypoglycemia and QoL (or related outcomes), had a quantitative design, and were published in a peer-reviewed journal after 2000. A protocol was registered the International Prospective Register of Systematic Reviews (PROSPERO; CRD42020154023). Studies were evaluated using the Joanna Briggs Institute’s critical appraisal tool. A narrative synthesis was conducted by outcome and hypoglycemia severity.

Results

In total, 27 studies met inclusion criteria. No hypoglycemia-specific measures of QoL were identified. Evidence for an association between SH and (domains) of generic and diabetes-specific QoL was too limited to draw conclusions, due to heterogenous definitions and operationalizations of hypoglycemia and outcomes across studies. SH was associated with greater worry about hypoglycemia, but was not clearly associated with diabetes distress, depression, anxiety, disordered eating or posttraumatic stress disorder. Although limited, some evidence suggests that more recent, more frequent, or more severe episodes of hypoglycemia may be associated with adverse outcomes and that the context in which hypoglycemia takes places might be important in relation to its impact.

Conclusions

There is insufficient evidence regarding the impact of hypoglycemia on QoL in children and adolescents with type 1 diabetes at this stage. There is a need for further research to examine this relationship, ideally using hypoglycemia-specific QoL measures.

To explore the association of Ramadan fasting with symptoms of depression, anxiety, and stress in people with diabetes

AIM

To explore the association of Ramadan fasting with symptoms of depression, anxiety, and stress in people with diabetes.

METHODS

This observational study was conducted at Baqai Institute of Diabetology and Endocrinology between May-July 2017. Informed consent was taken from each study participant. Demographic and baseline data was recorded. DASS-21 scale was used to assess symptoms of depression, anxiety, and stress pre and post Ramadan.

RESULTS

A total of one hundred and fifty people with diabetes participated in this study. 100 people were in fasting group and 50 were in non-fasting group. In fasting group pre-Ramadan depression, anxiety and stress symptoms were present in 45%, 45%,49% of people which improved to 23%, 26%, 35% post Ramadan (p-value <0.0001, <0.0001, 0.001) respectively. In non-fasting group pre-Ramadan depression and anxiety symptoms were present in 34%, and 50% of people, which improved to 30% and 40% post Ramadan (p-value 0.625, 0.227) respectively, while no improvement was observed in stress symptoms.

CONCLUSION

There is significant improvement in symptoms of depression, anxiety, and stress in people with diabetes post-Ramadan fasting.

Questionnaire on adaptation to type 1 diabetes among children and its relationship to psychological disorders

Objective:

to study the psychometric properties of an adaptive disease response questionnaire for use with Spanish children with type 1 diabetes; to analyse this response in this sample and to observe the relationship between adaptive response and levels of anxiety-depression.

Method:

a total of 100 patients with type 1 diabetes aged between nine and 16 years (M=12.28, SD=1.78) participated in the study, of which 59% were children. Data was collected in public hospitals via interviews using the Adaptive Disease Response Questionnaire and Anxiety and Depression Scale. The data was analysed using Pearson correlations, multiple hierarchical linear regressions, Student’s t Test for independent samples, and Cohen’s d effect size to determine reliability and validity.

Result:

the instrument was shown to have adequate psychometric properties. Adaptive response was generally high. Adaptive response is negatively related to emotional distress, being a better predictor of depression than of anxiety. There was no association betwee adaptation and sex and age.

Conclusion:

promoting a better adaptive response appears to reduce emotional distress, especially in the case of depression, regardless of the age or gender of the patients.