Medical and socio-demographic determinants of depressive disorders in diabetic patients
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Department of Medical Anthropology, Institute of Rural Health, Lublin, Poland
Institute of Rural Health, Lublin, Poland
Corresponding author
Magdalena Florek-Łuszczki   

Instytut Medycyny Wsi w Lublinie, ul. Jaczewskiego 2, 20-090, Lublin, Poland
Ann Agric Environ Med. 2020;27(2):255-259
Diabetes is a civilisation disease creating a serious challenge for public health. In Poland, approximately 2 million people suffer from diabetes, of which about 25% are unaware of their illness. A considerable part of persons with diabetes experience complications related with the disease.

The aim of the study was to determine the relationship between elements of the state of health and socio-demographic characteristics of diabetic patients treated in the Diabetes Clinic at the Institute of Rural Health (IMW) in Lublin, eastern Poland, and the occurrence of depressive symptoms in these patients.

Material and methods:
The study was conducted in 2017–2018 among patients treated in the Diabetes Clinic at the Institute of Rural Health in Lublin, by the method of a diagnostic survey using the Beck’s Depression Inventory and an author-constructed questionnaire, as well as data from the patients’ medical records. The study included 314 patients from the Diabetes Clinic who expressed their informed consent to participate in the research.

The study showed that diabetes is a disease which predisposes for the occurrence of depression. The occurrence of depressive symptoms of various degrees of intensity was confirmed in more than a half of the examined patients. Among the factors which exerted a significant effect on the occurrence of depressive symptoms were: diabetic neuropathy, type 2 diabetes, high BMI value, lack of occupational activity, poor material standard, and the need to obtain assistance in daily functioning due to the fact of being ill with diabetes.

It is necessary to implement routinely performed examinations into the diagnostic-therapeutic process to assess the state of psychological health of diabetic patients, which would allow sufficiently early application of appropriate psychological or psychiatric intervention.

1. [access date: 29.11.2019].
( [access date: 29.08.2019].
Boulton AJM, Vinik AI, Arezzo JC, Bril V, Feldman EL, Freeman R, et al. Diabetic neuropathies: A statement by the American Diabetes Association. Diabetes Care. 2005; 28: 956–962.
Boulton AJM, Malik RA, Arezzo JC, Sosenko JM. Diabetic somatic neuropathies. Diabetes Care. 2004; 27: 1458–1486.
Dyck PJ, Kratz KM, Karnes JL, et al. The prevalence by staged severity of various types of diabetic neuropathy, retinopathy, and nephropathy in a population-based cohort: The Rochester diabetic neuropathy study. Neurology. 1993; 43: 817–824.
Martin CL, Albers JW, Pop-Busui R, et al. Neuropathy and related findings in the diabetes control and complications trial/epidemiology of diabetes interventions and complications study. Diabetes Care. 2014; 37: 31– 38.
Pop-Busui R, Lu J, Brooks MM, et al. Impact of glycemic control strategies on the progression of diabetic peripheral neuropathy in the bypass angioplasty revascularization investigation 2 diabetes (BARI 2D) cohort. Diabetes Care. 2013; 36: 3208–3215.
Ismail-Beigi F, Craven T, Banerji MA, et al. Effect of intensive treatment of hyperglycaemia on microvascular outcomes in type 2 diabetes: An analysis of the ACCORD randomised trial. Lancet. 2010; 376: 419–430.
Ang L, Jaiswal M, Martin C, et al. Glucose control and diabetic neuropathy: Lessons from recent large clinical trials. Curr Diab Rep. 2014; 14: 1–15.
Schreiber AK, Nones CFN, Reis RC, Chichorro JG, Cunha JM, Diabetic neuropathic pain: Physiopathology and treatment. World J Diabetes. 2015; 6: 432–444.
Bansal V, Kalita J, Misra UK. Diabetic neuropathy. Postgrad Med J. 2006; 82: 95–100.
Tesfaye S, Boulton AJ, Dickenson AH. Mechanisms and management of diabetic painful distal symmetrical polyneuropathy. Diabetes Care. 2013; 36: 2456–2465.
Quattrini C, Tesfaye S. Understanding the impact of painful diabetic neuropathy. Diabetes Metab Res Rev. 2003; 19 Suppl 1: 2–8.
Gore M, Brandenburg NA, Dukes E, Hoffman DL, Tai KS, Stacey B. Pain severity in diabetic peripheral neuropathy is associated with patient functioning, symptom levels of anxiety and depression, and sleep. J Pain Symptom Manage. 2005; 30: 374–385.
American Psychiatric Association, Task F. Diagnostic and statistical manual of mental disorders DSM-5. Fifth edition 2013.
Roy T, Lloyd CE. Epidemiology of depression and diabetes: a systematic review. J Affect Disord. 2012; 142 (Suppl): S8–S21.
Ahmad A, Abujbara M, Jaddou H, Younes NA, Ajlouni K. Anxiety and depression among adult patients with diabetic foot: prevalence and associated factors. J Clin Med Res. 2018; 10: 411–418.
Abdulghani HM, AlRajeh AS, AlSalman BH, et al. Prevalence of diabetic comorbidities and knowledge and practices of foot care among diabetic patients: a cross-sectional study. Diabetes Metab Syndr Obes. 2018; 11; 417–425.
Wierzba W, Karnafel W, Tyszko P, Kanecki K, Śliwczyński A. Assessment of the incidence rate of end-stage renal disease in patients with and without diabetes in Poland. Ann Agric Environ Med. 2018; 25: 568–571.
Kvan E, Pettersen KI, Aasmund LS. High mortality in diabetic patients with acute myocardial infarction: Cardiovascular co-morbidities contribute most to the high risk. Int J Cardiol. 2007; 121: 84–88.
Jelinek HF, Osman WO, Khandoker AH, Khalaf K, Lee S, Almahmeed W, Alsafar HS. Clinical profiles, comorbidities and complications of type 2 diabetes mellitus in patients from United Arab Emirates. BMJ Open Diab Res Care. 2017;5:e000427. doi:10.1136/bmjdrc-2017–000427.
Agardh E, Allebeck P, Hallqvist J, Moradi T, Sidorchuk A. Type 2 diabetes incidence and socio-economic position: a systematic review and meta-analysis. Int J Epidemiol. 2011; 40: 804–818.
Folb N, Lund C, Fairall LR, Timmerman V, Levitt NS, Steyn K, Bachmann MO. Socioeconomic predictors and consequences of depression among primary care attenders with non-communicable diseases in the Western Cape, South Africa: cohort study within a randomised trial. BMC Public Health. 2015; 15: 1194.
24. [access date: 20.12.2019].
Tovilla-Za´rate C, Jua´rez-Rojop I, Jimenez YP, et al. Prevalence of anxiety and depression among outpatients with type 2 diabetes in the Mexican population. PLoS One 2012; 7(5): e36887. doi:10.1371/journal.pone.0036887.
Carnethon MR, Biggs ML, Barzilay JI, et al. Longitudinal association between depressive symptoms and incident type 2 diabetes mellitus in older adults: the Cardiovascular Health Study. Arch Intern Med. 2007; 167: 802–807.
Musselman DL, Betan E, Larsen H, Phillips LS. Relationship of depression to diabetes types 1 and 2: epidemiology, biology and treatment. Biol. Psychiatry 2003; 54: 317–329.
Eaton WW, Armenian H, Gallo J, et al. Depression and risk for onset of type II diabetes: a prospective population-based study. Diabetes Care. 1996; 19: 1097–1102.
Sharif S, Raza MT, Mushtaq S, Afreen B, Hashmi BA, Ali MH. Frequency of depression in patients with type 2 diabetes mellitus and its relationship with glycemic control and diabetic microvascular complications. Cureus 2019; 11: e5145. doi: 10.7759/cureus.5145.
Katon W, Von Korff M, Ciechanowski P, Russo J, Lin E, Simon G, et al. Behavioral and clinical factors associated with depression among individuals with diabetes. Diabetes Care. 2004; 27: 914–920.
de Groot M, Anderson R, Freedland KE, Clouse RE, Lustman PJ. Association of depression and diabetes complications: a meta-analysis. Psychosom Med. 2001; 63: 619– 630.
Gendelman N, Snell-Bergeon JK, McFann K, et al. Prevalence and correlates of depression in individuals with and without type 1 diabetes. Diabetes Care. 2009; 32: 575–579.
D’Amato C, Morganti R, Greco C, et al. Diabetic peripheral neuropathic pain is a stronger predictor of depression than other diabetic complications and comorbidities. Diab Vasc Dis Res. 2016; 13: 418–428.
Gonzalez JS, Peyrot M, McCarl LA, Collins EM, Serpa L, Mimiaga MJ, Safren SA. Depression and diabetes treatment nonadherence: a meta-analysis. Diabetes Care. 2008; 31: 2398–2403.
Baumeister H, Hutter N, Bengel J, Harter M. Quality of life in medically ill persons with comorbid mental disorders: a systematic review and meta-analysis. Psychother Psychosom. 2011; 80: 275–286.
Egede LE, Nietert PJ, Zheng D. Depression and all-cause and coronary heart disease mortality among adults with and without diabetes. Diabetes Care. 2005; 28: 1339–1345.
Hofmann M, Kohler B, Leichsenring F, Kruse J. Depression as a risk factor for mortality in individuals with diabetes: a meta-analysis of prospective studies. PLoS One. 2013; 8(11): e79809.
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