Prevalence of Depression in Patients with Type II Diabetes Mellitus and its Impact on Quality of Life

BACKGROUND

Diabetes mellitus (DM) is a frequently encountered chronic metabolic disease with various complications throughout its course, which causes severe restriction and disability in an individual's life. It has been well documented that the incidence of depression is higher in diabetic patients and co-morbid depression causes further deterioration in the quality of life in diabetic patients.

AIMS

To study the prevalence of depression and its impact on quality of life in patients with type II DM.

SETTINGS AND DESIGN

Single centre, cross-sectional, single interview.

MATERIALS AND METHODS

Total 195 type II DM patients are included in this study. To diagnose Depressive Episode Structured Clinical Interview for DSM IV Axis-1 Disorders, Research Version patient edition was applied. All patients were evaluated with a semi-structured socio-demographic proforma to assess socio-demographic characteristics, Hamilton Rating Scale for Depression (HAM-D) and Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) SF (Short Form) to measure the quality of life.

RESULTS

Among them, 46.15% (N=90; males: 41, females: 49) met the DSM-IV diagnostic criteria for major depressive episodes. Among the depressed group, majority were (36.7%) moderately depressed. QLESQ-SF total and each item scores were significantly lower in the depressed group than in the non-depressed group. Both the HAM-D scores and HbA1c level have significant negative correlations with QLESQ-SF total scores.

CONCLUSION

Our study demonstrates that the presence of depression in type II DM further deteriorates the quality of life of the patients. Therefore, treating depression would have a beneficial effect on the quality of life.

Evidence for alternative binding modes in the interaction of benzylamine analogues with bovine liver monoamine oxidase B

The interaction of purified bovine liver MAO B with the benzylamine analogues N,N-dimethylbenzylamine and alpha-methylbenzylamine has been investigated. Both classes of analogues are competitive inhibitors of benzylamine oxidase activity. The K(i) values were determined for nine different para-substituted N, N-dimethylbenzylamine analogues. Analysis of the binding affinities demonstrate the deprotonated forms of the tertiary amines are preferentially bound to MAO B and the affinity decreases with increasing van der Waals volume of the para-substituent. The correlation for this relation is:Log K(i)=-0.97+/-(0.28)sigma+(0. 75+/-0.11)(0.1xV(w))-4.24+/-(0.16)alpha-Methyl benzylamine analogues are also found to be competitive inhibitors of MAO B-catalyzed benzylamine oxidation. Similar K(i) values were determined using either the S or R stereoisomers. Analysis of the binding affinities of five para-substituted alpha-methylbenzylamine analogues to MAO B shows the deprotonated form also to be preferentially bound and the affinity is marginally increased with increasing van der Waals volume of the para-substituent:Log K(i)=-0.71sigma-(0.32)(0. 1xV(w))-3.50Comparison of these data with that previously published for para-substituted benzylamine binding to MAO B (Walker and Edmondson, Biochemistry 33 (1994) 7088-7098) demonstrates that these benzylamine analogues exhibit differing modes of binding to the active site of MAO B. The presence of an electronic substituent effect in the binding of these two classes of analogues compared with the lack of an observable electronic effect in the binding of benzylamine to MAO B is consistent with the proposal that orientation of the benzyl ring of the bound substrate is responsible for the absence of an electronic substituent effect on the rate of the reductive half reaction (Miller and Edmondson, Biochemistry 38 (1999) 13670-13683).

Segmental analysis of coronary arterial stenoses in patients presenting with angina or first myocardial infarction

The segmental distribution of stenoses within the coronary arteries was analysed in a population of 258 patients with a first myocardial infarction undergoing coronary angiography to evaluate the effect of thrombolytic therapy, and in a population of 466 patients undergoing elective coronary angiography for stable angina. Mean ages were 53.7 and 56.7 years respectively (P = NS). As judged angiographically, coronary arterial disease was more extensive in the group suffering angina, with a greater proportion of patients with two- or three-vessel disease (odds ratio 2.56, 95% confidence interval 1.87 to 3.52) and more patients having stenoses in two or more coronary arterial segments (odds ratio 1.52, 95% confidence interval 1.12 to 2.08). For each coronary vessel, the probability of finding a stenosis greater than 50% in an individual segment was greater in the group presenting with angina. There was a relative deficiency of stenoses within the main stem of the left coronary artery or its proximal left anterior descending branch among the patients suffering myocardial infarction. Within those having angina, subgroups were identified with "isolated" and "diffuse" coronary arterial disease: the latter patients tended to have a lower concentration of total cholesterol in the serum, but an increased prevalence of diabetes mellitus. Patients presenting clinically with a first myocardial infarction, and patients with severe angina, constitute distinct populations selected by different mechanisms from the overall pool of patients with atheromatous coronary arterial disease.