Abstract
BackgroundThe aim of the study was to estimate the prevalence of depression in the population diagnosed with diabetes type 2 and to test the hypothesis that the presence of depression in such cases was associated with a) worse glycaemic control, and b) higher healthcare costs.MethodsWe conducted a cross-sectional analysis, from 1st September 2010 to 31st August 2011, among patients with type 2 diabetes aged 35 years and over in the Basque Country. It was identified how many of them had also depression. The database included administrative individual level information on age, sex, healthcare costs, other comorbidities, and values of glycaemic control (HbA1c). Deprivation index variable was used as socioeconomic measure and, to observe the coexistent pathologies, all the patients diagnoses were categorized by Adjusted Clinical Groups. We used a measure of association, a logistic and a linear regression for analysis.Results12.392 (9.8%) of type 2 diabetes patients were diagnosed with depression, being the prevalence 5.2% for males and 15.1% for females. This comorbidity was higher among the most deprived population. There was no association between the presence of depression and glycaemic control. We estimated that the comorbidity average cost per patient/year was 516€ higher than in patients with just type 2 diabetes (P < 0.001) adjusted by the other covariates.ConclusionsWe did not find any relationship between depression and glycaemic control in patients with type 2 diabetes. However, the comorbidity was associated with significantly high healthcare costs compared to that of type 2 diabetes occurring alone, after adjusting by other illness. Thus, there is a need of more precise recognition, screening and monitoring of depression among diabetic population. Evidence-based treatment for depression should be included in type 2 diabetes clinical guidelines.
Highlights
The aim of the study was to estimate the prevalence of depression in the population diagnosed with diabetes type 2 and to test the hypothesis that the presence of depression in such cases was associated with a) worse glycaemic control, and b) higher healthcare costs
The difference between the richest quintile and the poorest quintile was around a 1% and there was a relationship between socioeconomic level and the comorbidity (p value of Pearson X2 < 0.001) for the total, males and females (p < 0.001)
A meta-analysis of 42 published studies found that the prevalence of major depression among patients with diabetes type 2 was 11% [10] and Roy T. et al [14] reported a prevalence of depression two times higher among patients with type 2 diabetes than in general population
Summary
The aim of the study was to estimate the prevalence of depression in the population diagnosed with diabetes type 2 and to test the hypothesis that the presence of depression in such cases was associated with a) worse glycaemic control, and b) higher healthcare costs. Presence of additional diagnosis of depression in patients with type 2 diabetes can negatively influence control, treatment and outcomes of both diseases [8]. According to World Health Surveys [9] conducted in 2007, combination of two or more chronic conditions with depression obtained the lowest scores making diabetes and its complications the worst combination for depression (comparing it to combination of depression with other chronic conditions such as asthma or angina), in terms of the worst quality of life and disability
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