Depression in diabetes mellitus—A comprehensive systematic review of literature from an Indian perspective

• Published in: Asian journal of psychiatry 2017-06, Vol.27, p.85-100
• Main Authors: Naskar, Subrata, Victor, Robin, Nath, Kamal
• Format: Article
• Language: English
• Subjects: Comorbidity; Demographics; Depression; Depressive Disorder - epidemiology; Developing country; Diabetes Complications - epidemiology; Diabetes mellitus; Diabetes Mellitus, Type 1 - epidemiology; Diabetes Mellitus, Type 2 - epidemiology; Epidemiology; Humans; India; India - epidemiology; Internal Medicine; Prevalence; Psychiatry; Risk factors; Systematic review
• ISSN: 1876-2018; 1876-2026
• DOI: 10.1016/j.ajp.2017.02.018

Highlights • The prevalence rate of depression among diabetic patients in India varies widely between 2%-84%, as seen in the reviewed literature. This range varies widely from the data obtained in western countries, as reported by both controlled and uncontrolled studies conducted there. Possible reasons are use of different methodology in different studies along with sociodemographic differences. • Depression in T2DM seems to be prevalent more in the northern states of India than the southern states. Increasing age, with age above 50 years shows statistically significant association between diabetes and depression. Other risk factors that have come up in the review are female gender, low literacy rate, burden of being from a lower socioeconomic status, rural domicile, marriage and duration of Type 2 diabetes mellitus of >2 years. • Sedentary life without adequate physical activities, lack of self-care, and fatigue are often the factors that precipitates depression in a Type 2 diabetes mellitus patient and vice versa. Poor glycaemic control as indicated by recently elevated fasting blood glucose level as well as elevated HbA1c has a strong association with the precipitation of depression in diabetic patients. • Predominantly the complications of Type 2 diabetes mellitus that have been reported to have significant association with depression are neuropathy, nephropathy, retinopathy and coronary artery disease. Hypertension and dyslipidaemia are the two most commonly associated comorbidities of these patients. Absence of microvascular complications reduces the chance of depression in diabetic patients. • There is a serious lack of longitudinal and controlled Indian studies on the topic of depression in diabetes mellitus. There is sparse Indian data on the relationship between Type 1 diabetes mellitus and depression.