Abstract
BackgroundThis study aims to describe trends in the prevalence of depression among hospitalized patients with type 2 diabetes in Spain, 2001–2011.MethodsWe selected patients with a discharge diagnosis of type 2 diabetes using national hospital discharge data. Discharges were grouped by depression status. Prevalence of depression globally and according to primary diagnoses based on the Charlson comorbidity index (CCI) were analyzed. We calculated length of stay (LOHS) and in-hospital mortality (IHM). Multivariate analysis was adjusted by age, year and comorbidity.ResultsFrom 2001 to 2011, 4,723,338 discharges with type 2 diabetes were identified (4.93% with depression). Prevalence of depression in diabetic patients increased from 3.54% in 2001 to 5.80% in 2011 (p<0.05). The prevalence of depression was significantly higher in women than in men in each year studied and increased from 5.22% in 2001 to 9.24% in 2011 (p<0.01). The highest prevalence was observed in the youngest age group (35–59 years). The median LOHS decreased significantly over this period. Men with diabetes and depression had higher IHM than women in all the years studied (p<0.05). Older age and greater comorbidity were significantly associated with a higher risk of dying, among diabetic patients with concomitant depression.ConclusionsPrevalence of depression increased significantly among hospitalized diabetic patients from 2001 to 2011 even if the health profile and LOHS have improved over this period. Programs targeted at preventing depression among persons with diabetes should be reinforced in Spain.
Highlights
The prevalence of depression is higher in patients with type 2 diabetes (T2DM), compared with those without diabetes [1,2,3]
Prevalence of depression increased significantly among hospitalized diabetic patients from 2001 to 2011 even if the health profile and length of hospital stay (LOHS) have improved over this period
Programs targeted at preventing depression among persons with diabetes should be reinforced in Spain
Summary
The prevalence of depression is higher in patients with type 2 diabetes (T2DM), compared with those without diabetes [1,2,3]. Epidemiological studies conducted in Spain have confirmed this finding [4, 5] The studies linking these two comorbid conditions support the hypothesis of a bi-directional relationship between diabetes and depression, indicating that depression itself is a risk factor for the development of diabetes [6,7,8,9,10]. The increased risk of T2DM in individuals with depression could result from increased counter-regulatory hormone release and action, alterations in glucose transport function, and increased immunoinflammatory activation [7]. These physiologic alterations are thought to contribute to insulin resistance and beta islet cell dysfunction, which lead to the development of T2DM. This study aims to describe trends in the prevalence of depression among hospitalized patients with type 2 diabetes in Spain, 2001–2011.
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