Abstract
This study aims to describe the prevalence of depression and anxiety among a population sample of people at high risk for type 2 diabetes in Kerala, India, and examine the relationship between depressive symptoms, anxiety, and incident Type 2 Diabetes Mellitus (T2DM) over a two-year period. We used data from the Kerala Diabetes Prevention Program, a cluster-randomized controlled trial for diabetes prevention among 1007 high-risk individuals. The prevalence of depression and anxiety were estimated using the 9-item Patient Health Questionnaire and the Generalized Anxiety Disorder 7-item scale, respectively. We calculated proportions for depression and anxiety and performed generalized estimating equations (GEE) to examine the relationship between baseline mental health status and incident T2DM. The prevalence of depression and anxiety at baseline were 7.5% and 5.5%, respectively. Compared with those reporting none/low symptoms, the odds ratio for incident diabetes was 1.07 (95% CI 0.54–2.12) for participants with moderate to severe depression and 0.73 (95% CI 0.23–2.28) for participants with moderate to severe anxiety, after adjusting for potential confounders. Our findings suggest that the prevalence of depression and anxiety were higher than those previously reported in the general population in India. However, among this sample of community-based adults at high risk of developing T2DM, the presence of moderate to severe depression and/or anxiety symptoms was not significantly associated with the risk of developing T2DM.Trial registration: Australia and New Zealand Clinical Trials Registry ACTRN12611000262909. Registered 10 March 2011.
Highlights
Addressing common mental disorders (CMDs), such as depression and anxiety, has become a global health priority; CMDs account for around a third of non-fatal disease burden worldwide and around 10 percent of overall disease burden [1]
Of 32 studies conducted from 1980–2016 examining the risk of diabetes in adults with depression, only two were conducted in low and middle-income countries (LMICs); with the highest documented risk for diabetes among people with depression occurring in South Asia [3,4,5]
The correlation was stronger between central obesity and type 2 diabetes mellitus (T2DM) compared to obesity based on Body mass index (BMI) among Kerala Diabetes Prevention Program (K-DPP) participants (34), we considered central obesity as the measure of adiposity in the analyses
Summary
Addressing common mental disorders (CMDs), such as depression and anxiety, has become a global health priority; CMDs account for around a third of non-fatal disease burden worldwide and around 10 percent of overall disease burden [1]. CMDs can have a very detrimental impact on an individual’s well-being and often co-occur with other chronic conditions [2] such as type 2 diabetes mellitus (T2DM) and cardiovascular diseases. A meta-analysis examining the relationship between depression and incident diabetes found that 8 of 15 studies demonstrated an increased risk of T2DM among those with depression [3]. These studies found a 1.41 fold increase in risk or 1.24 fold increase in hazard for T2DM among adults with depression [3]. Of 32 studies conducted from 1980–2016 examining the risk of diabetes in adults with depression, only two were conducted in low and middle-income countries (LMICs); with the highest documented risk for diabetes among people with depression occurring in South Asia [3,4,5]
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