Anxiety Among Patients With Diabetes Mellitus Evaluated Using Generalized Anxiety Disorder 7-item Scale
Background: Anxiety has been shown to be associated with poor outcomes in people with diabetes. However, there has been limited data, especially from India, which has specifically examined whether diabetes mellitus is associated with an increased likelihood of comorbid anxiety. Aim: The aim was to estimate the prevalence of anxiety in patients with diabetes and to determine the association of anxiety with age, sex, and other related parameters. Setting: Endocrine clinic, tertiary care hospital. Design: Cross-sectional. Materials and Methods: The study was cross-sectional carried out in endocrinology clinic of tertiary care hospital in North India. Cases were patients with type 2 diabetes mellitus above 30 years of age. Anxiety was assessed using the generalized anxiety disorders 7-item (GADs-7) scale. The relationship with a sociodemographic profile, duration of diabetes, hypertension, and microvascular complications was also analyzed. Results: Seventy-three subjects (42.5% females) with mean age 50.8 ± 9.2 years were evaluated. The prevalence of anxiety was 34%. Severe anxiety (GAD-7 score ≥15) was present in three (4%) subjects, moderate anxiety (GAD-7 score ≥10) was present in six (8%) subjects, and mild anxiety was present in 16 (22%) of subjects. Anxiety increased with fasting plasma glucose, hypertension, was more in women, but the differences were not statistically significant. Conclusions: Our study demonstrates a higher prevalence of anxiety in patients with type 2 diabetes. No factor was significantly associated with anxiety. Therefore, anxiety should be assessed in each and every patient, irrespective of other factors. Continue reading >>
A Cross Sectional Study On Prevalence And Factors Influencing Anxiety And Depression Among Patients With Type Ii Diabetes Mellitus
DOI: Abstract Background: Numerous study findings documented higher risk of depression and anxiety that diabetic population. Anxiety and depression in turn are proven to have strong negative influence on glycemic control, complications and quality of life in diabetic patients. Major portion of evidence linking DM, depression and anxiety comes from developed countries, and there is scarcity of research in this regard in developing and low-income countries. Aim of the study was to assess the prevalence of depression and anxiety and factors associated with them in type II diabetes mellitus patients. Methods: The study was a descriptive cross sectional study, conducted in a tertiary care teaching hospital. The study included 135 sequentially recruited type II diabetic patients. Hamilton Depression Rating Scale (HAM-D) and Hamilton Anxiety Rating Scale (HAM-A) were used to assess the severity of depression/anxiety. Results: A total of 135 participants were included in the study. More than half (59.3%) of the study subjects have reported history of perceived stress. The proportions of subjects, reporting either anxiety or depression were 64.4%. Depression alone was present in 60.7% of the subjects and anxiety alone was present in 44.4% of the subjects. New onset of diabetes mellitus (Odds ratio 3.51, 95% CI 1.3 to 5.38), presence of diabetic neuropathy (Odds ratio 1.64, 95% CI 1.28 to 3.57), presence of diabetic retinopathy (Odds ratio 2.70, 95% CI 1.63 to 6.78) and history of perceived stress (Odds ratio 40.32, 95% CI 10.95 to 148.32), were associated with anxiety and depression. Conclusions: Prevalence of depression and anxiety was very high in diabetic population; hence evaluation and management should be part of routine care. Special focus should be given to patients with Continue reading >>
- Prevalence of diabetes and prediabetes in 15 states of India: results from the ICMR–INDIAB population-based cross-sectional study
- Diagnostic accuracy of resting systolic toe pressure for diagnosis of peripheral arterial disease in people with and without diabetes: a cross-sectional retrospective case-control study
- Prevalence of and Risk Factors for Diabetic Peripheral Neuropathy in Youth With Type 1 and Type 2 Diabetes: SEARCH for Diabetes in Youth Study
Telehealth Did Not Improve Quality Of Life, Anxiety And Depressive Symptoms In Patients With Diabetes
As pressure increases on an over-burdened healthcare system, focusing on self-care has potential. Advances in technology have improved many aspects of healthcare: now its uses may be harnessed to reduce utilisation of health services by those with long term conditions. “Telehealth” is an assistive technology that allows individuals to exchange information with their healthcare professional remotely. Ideally this would facilitate diagnosis, monitoring and management of long-term conditions. In February 2013, the British Medical Journal published a study funded by the Policy Research Programme in the UK Department of Health that focused on the Whole Systems Demonstrator (WSD) Evaluation telehealth questionnaire study. It aimed to see if a home-based telehealth system could improve Health-related quality of life (HRQoL), anxiety and depressive symptoms over a 12 month period. Methods This paper reports on the WSD telehealth questionnaire study, which is part of a wider cluster randomised control trial of telehealth. This large scale trial compared telehealth to usual care and was conducted between May 2008 and December 2009. Participants were recruited from three diverse regions of England (Cornwall, Kent, and Newham). Eligible patients were diagnosed with chronic obstructive pulmonary disease (COPD), diabetes or heart failure, as confirmed by a local clinician or hospital consultant. The intervention focused on monitoring vital signs, symptoms and the self-management of behaviour. Data was collected at baseline, 4 months and 12 months. Across 154 sites, 1573 participants provided questionnaire data at baseline. Over two thirds completed the questionnaires at 2 time points, with 45.1% assessed at all 3 time-points. The main outcomes of the study were assessed by self-r Continue reading >>
The Symptoms Of Depression And Anxiety In Patients With Diabetic Foot Treated With Hyperbaric Oxygen - Preliminary Results
The aim of the study was to assess the level of anxiety and depressiveness in patients who had qualified for hyperbaric oxygen therapy (HBOT) for the treatment of ulcerative lesions in the lower limbs, occurring as a result of diabetic foot syndrome (DFS),. A total of 50 patients with type 2 diabetes and diabetic foot syndrome were enrolled to the study. All patients have received 30 sessions of HBOT. During the therapy blood glucose was measured and photographic documentation was carried out. All patients underwent the following procedures: medical history and socioeconomic interview, psychiatric examination, self-report and objective psychometric tests to measure anxiety and depressiveness. Based on the obtained results, we reported that patients with a greater degree of tissue damage had higher levels of depressive symptoms in the self-report tests as well as in the objective evaluation of the investigator. In terms of location of ulcerative lesions - the level of depressiveness was greater when the affected area included toes, and the level of anxiety was increased when it concerned the heel. Regarding other parameters, statistically significant correlations were not observed. Continue reading >>
Alexithymia In Patients With Type 2 Diabetes Mellitus: The Role Of Anxiety, Depression, And Glycemic Control
Go to: Abstract This study was aimed at determining the prevalence of alexithymia in patients with type 2 DM and the factors affecting it. This cross-sectional study was conducted with 326 patients with type 2 DM. Study data were collected with the Personal Information Form, Toronto Alexithymia Scale, and Hospital Anxiety and Depression Scale. Glycemic control was assessed by glycated haemoglobin (HbA1c) results. The analysis was performed using descriptive statistics, chi-square test, Pear-son’s correlation, and logistic regression analysis. Of the patients, 37.7% were determined to have alexithymia. A significant relationship was determined between alexithymia and HbA1c, depression, and anxiety. According to binary logistic regression analyses, alexithymia was 2.63 times higher among those who were in a paid employment than those who were not, 2.09 times higher among those whose HbA1c levels were ≥7.0% than those whose HbA1c levels were <7.0%, 3.77 times higher among those whose anxiety subscale scores were ≥11 than those whose anxiety subscale scores were ≤10, and 2.57 times higher among those whose depression subscale scores were ≥8 than those whose depression subscale scores were ≤7. In this study, it was determined that two out of every five patients with DM had alexithymia. Therefore, their treatment should be arranged to include mental health care services. Keywords: diabetes mellitus, alexithymia, mental symptoms, HbA1c Continue reading >>
- The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus
- Type 2 Diabetes and Comorbid Symptoms of Depression and Anxiety: Longitudinal Associations With Mortality Risk
- Anxiety and Depression May Increase Mortality Risk in Type 2 Diabetes
Anxiety And Depression Among Outpatients With Type 2 Diabetes: A Multi-centre Study Of Prevalence And Associated Factors
Abstract Anxiety and depression contribute to poor disease outcomes among individuals with diabetes. This study aimed to assess the prevalence of anxiety and depression and to identify their associated factors including metabolic components among people with type 2 diabetes. We conducted a cross-sectional, multi-center study in four out-patient clinics in Karachi, Pakistan. In all, 889 adults with type-2 diabetes were included in this study. Anxiety and depression were measured by using the Hospital Anxiety and Depression Scale (HADS). Multivariable analysis using multiple logistic regression was carried out to evaluate the combined effect of various factors associated with anxiety and depression, while adjusting for confounding variables. Overall, 57.9% (95% CI = 54.7%, 61.2%) and 43.5% (95% CI = 40.3%, 46.8%) study participants had anxiety and depression respectively. Factors found to be independently associated with anxiety were physical inactivity, having hypertension and ischemic heart disease. For depression, being female, of older age, having hypertension and ischemic heart disease were significantly associated. Metabolic components found to be independently associated with both anxiety and depression were systolic blood pressure, fasting blood glucose and fasting blood triglycerides. Body mass index was independently associated with depression but not with anxiety. This study identified that a large proportion of adults with diabetes had anxiety and/or depression, and identified factors associated with these entities. These results alert clinicians to identify and treat anxiety and depression as common components of diabetes care. Additional studies are needed to establish the directional nature of this relationship and to test interventions. Background The glob Continue reading >>
- Prevalence of and Risk Factors for Diabetic Peripheral Neuropathy in Youth With Type 1 and Type 2 Diabetes: SEARCH for Diabetes in Youth Study
- Type 2 Diabetes and Comorbid Symptoms of Depression and Anxiety: Longitudinal Associations With Mortality Risk
- Anxiety and Depression May Increase Mortality Risk in Type 2 Diabetes
Is There A Link Between Diabetes And Depression? Know The Facts
Some studies show that having diabetes doubles your risk of developing depression. If diabetes-related health problems emerge, your risk for depression can increase even further. It remains unclear exactly why this is. Some researchers suggest that this could be due to diabetes' metabolic effect on brain function as well as the toll day-to-day management can take. It’s also possible that people with depression are more likely to develop diabetes. Because of this, it’s recommended that people who have a history of depression be screened for diabetes. Keep reading for more on the connection between diabetes and depression, as well as information on diagnosis, treatment, and more. Although more research is needed to fully understand the link between diabetes and depression, it’s clear that there’s a connection. It’s thought that alterations in brain chemistry tied to diabetes may be related to the development of depression. For example, damage resulting from diabetic neuropathy or blocked blood vessels in the brain may contribute to the development of depression in people with diabetes. Conversely, changes in the brain due to depression may cause an increased risk for complications. Studies have shown that people with depression are at higher risk for diabetes complications, but is has been difficult to determine which causes which. It hasn’t been determined if depression increases the risk for complications, or vice versa. Symptoms of depression can make it more difficult to successfully manage diabetes and prevent diabetes-related complications. A 2011 study found that people who have type 2 diabetes and experience symptoms of depression often have higher blood sugar levels. Additionally, the results of a separate 2011 study suggest that people who have both Continue reading >>
Depression And Anxiety After 2 Years Of Follow-up In Patients Diagnosed With Diabetes Or Rheumatoid Arthritis
Emotional co-morbidity among people suffering from a chronic somatic illness affects the symptom pattern, so that individuals with a comorbid emotional disorder report more somatic symptoms than those without emotional disorders (Katon et al., 2007). For instance, comorbid depression in chronic somatic diseases seems to worsen health more than the somatic disease or the depression in itself (Moussavi et al., 2007). Besides, somatic symptoms in such patients seem to be at least as strongly associated with the comorbid depression or anxiety, as with more objective physiologic measures (Katon et al., 2007). In diabetes mellitus (DM) patients, emotional disorders are more common than in the general population (Wändell et al., 2014), especially anxiety and depression which also often are difficult to detect by the healthcare staff (Poulsen et al., 2016), and also show a deep impact on quality of life (Goldney et al., 2004; Wändell, 1999). Emotional disorders also have a negative impact on disease management (Katon et al., 2007), which can accelerate diabetes progression as well. Treatment of depression in diabetes is shown to improve depression symptoms and also positively affect health economy costs (Simon et al., 2007). In rheumatoid arthritis (RA) patients, depression and anxiety are also more common than in the general population (Dickens et al., 2002; Isik et al., 2007). Treatment of depression in patients with RA has been shown to relieve not only symptoms of depression but also pain, to improve functional status and quality of life (Lin et al., 2003), and also to increase the response to treatment (Santiago et al., 2015). When living with a chronic disease, the process of adaptation is important, and coping is an important psychological factor in this (De Ridder and Continue reading >>
Prevalence And Impact Of Anxiety And Depression On Type 2 Diabetes In Tunisian Patients Over Sixty Years Old
Depression Research and Treatment Volume 2013 (2013), Article ID 341782, 6 pages 1Department of Psychiatry A, University Medical Center Hédi Chaker, 3000 Sfax, Tunisia 2Department of Functional Exploration and Metabolic Diseases, University Medical Center Habib Bourguiba, 3000 Sfax, Tunisia 3Department of Psychiatry, University Medical Center Fattouma Bourguiba, 5000 Monastir, Tunisia Academic Editor: H. Grunze Copyright © 2013 Jawaher Masmoudi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Objectives. To estimate the prevalence of anxiety and depression using the Hospital Anxiety and Depression Scale (HADS) in a population aged over sixty years with type 2 diabetes and to study the impact of anxiety and depression on glycemic balance and disease outcome. Results. The prevalence of anxiety and depression in the 62 subjects included in the study was, respectively, 40.3% and 22.6%. We found a relationship between these disorders and complicated diabetes. The subjects having an imperfectly balanced diabetes had a higher average anxiety score than those having a good glycemic control ( versus ; ). No relationship was found between diabetes balance and depression. Conclusion. Association between anxiety and depressive disorders and diabetes is frequent and worsens patients’ outcome, in terms of diabetes imbalance as well as in terms of diabetic complications. Our study shows that there is need for physicians to detect, confirm, and treat anxiety and depressive disorders in elderly diabetic patients. 1. Introduction In Tunisia, the proportion of individuals over 60 years is increasing, an Continue reading >>
My Site - Chapter 18: Diabetes And Mental Health
Psychiatric disorders, particularly major depressive disorder (MDD), generalized anxiety disorder and eating disorders, are more prevalent in people with diabetes compared to the general population. People diagnosed with serious mental illnesses, such as MDD, bipolar disorder and schizophrenia, have a higher risk of developing diabetes than the general population. All individuals with diabetes should be regularly screened for the presence of depressive and anxious symptoms. Compared to those with diabetes only, individuals with diabetes and mental health disorders have decreased medication adherence, decreased compliance with diabetes self-care, increased functional impairment, increased risk of complications associated with diabetes, increased healthcare costs and an increased risk of early mortality. The following treatment modalities should be incorporated into primary care and self-management education interventions to facilitate adaptation to diabetes, reduce diabetes-related distress and improve outcomes: motivational interventions, stress management strategies, coping skills training, family therapy and collaborative case management. Individuals taking psychiatric medications, particularly atypical antipsychotics, benefit from regular screening of metabolic parameters. Research is increasingly demonstrating a relationship between mental health disorders and diabetes. Patients with serious mental illnesses, particularly those with depressive symptoms or syndromes, and patients with diabetes share reciprocal susceptibility and a high degree of comorbidity ( Figure 1 ). The mechanisms behind these relationships are multifactorial. Some evidence shows that treatment for mental health disorders may actually increase the risk of diabetes, particularly when second-gene Continue reading >>
Relationships Between Quality Of Life, Anxiety, Depression And Diabetes
Research Article 1Department of Integrated Medical Care, Medical University of Bialystok, Poland 2Department of Nursing, School of Medical Science in Bialystok, Poland *Corresponding author: Jolanta Lewko, Department of Integrated Medical Care, Medical University of Bialystok, 7A M. Sklodowskiej-Curie Str., 15-096 Bialystok, Poland Abstract A chronic disease such as diabetes significantly affects the life of the individual and their family. It lowers quality of life, results in loss of physical strength and sense of safety, which in turn leads to a feeling of uselessness and the development of anxiety and depression. Diabetic patients with symptoms of depression have lower quality of life than patients with diabetes without depression. Lack of acceptance of a chronic disease such as diabetes also significantly reduces patient quality of life. Increased awareness and monitoring of cases of depression are needed in different areas of diabetes care, because among patients with diabetes who suffer from depression, neuropathy, retinopathy, pain, worse general health, and lack of social support occur more often than in patients with diabetes without depression. The patient’s psychological well-being affects almost all aspects of therapeutic and nursing interventions. Keywords: Diabetes; Quality of life; Anxiety; Depression Introduction Diabetes is a chronic disease that significantly affects the life of the individual and their family. It lowers quality of life, physical strength, and sense of safety. This results in the inability to undertake any activity, which in turn leads to a feeling of uselessness and the development of depression and anxiety. Anxiety disorders and depression has been the subject of many studies conducted among patients with diabetes because of its a Continue reading >>
High-risk Alcohol Use And Anxiety And Depression Symptoms In Adolescents And Adults With Type 1 Diabetes Mellitus: A Cross-sectional Study
Abstract The medical literature shows that alcohol consumption is common among diabetic individuals and is associated with poor adherence to treatment, resulting in increased morbidity and mortality. However, no study has assessed the association between high-risk alcohol consumption and the presence of anxiety and depression in individuals with type 1 diabetes mellitus (1DM). The present cross-sectional study was conducted in Uberlândia, Brazil, and it assessed 209 outpatients in relation to alcohol consumption and the presence of anxiety and depression symptoms, using the Alcohol Use Disorders Identification Test (AUDIT), the Hospital Anxiety and Depression (HAD) scale, and glycemic control, according to the levels of glycated hemoglobin (HbA1c). The chi-square test and logistic regression analysis were used to investigate the association between the investigated variables. The prevalence of high-risk alcohol consumption (AUDIT ≥ 8) among individuals with 1DM was high, specifically 24.9% among the entire group of subjects, 12.9% among the adolescents, 14.7% among the females, and 34.6% among the males. In comparisons based on gender and age, the odds of high-risk drinking were higher among males and participants aged 30 to 40 years (33.9%). The frequency of high-risk alcohol consumption did not differ as a function of gender among adolescents (females: 9.0%, males: 16.2%; p = 0.374). There was a linear trend in proportions related to the scores of anxiety and depression symptoms with high-risk alcohol consumption scores, indicating the association of these variables (p = 0.0229 and p = 0.0262, respectively). Moreover, the odds of female subjects exhibiting anxiety and depression symptoms were higher (odds ratio – OR: 4.4 and OR: 7.4, respectively). Glycemic contr Continue reading >>
Prevalence Of Depression, Anxiety And Cognitive Impairment In Patients With Type 2 Diabetes From The Central Part Of Romania
Objective: The aim of this study was to assess the prevalence of depression, anxiety and cognitive impairment in patients with type 2 diabetes (T2D). Material and methods: We conducted a cross-sectional study in patients with T2D. Depression and anxiety were assessed by questionnaires (PHQ-9, CES-D and GAD-7 respectively), cognitive function by the MoCA test. Additionally, 503 patients’ clinic charts were separately analyzed in order to compare the data recorded in the charts with that resulted from the active assessment. Results: In the screening study 216 subjects with T2D were included (62.2 ± 7.8 years old). 34.3% of them had depression and 7.4% presented major depression. 44.9% of patients with T2D had anxiety (9.2% major anxiety) and this was highly correlated with depression (OR: 21.139, 95%CI: 9.767-45.751; p<0.0001). Women had significantly higher prevalence of depression and anxiety compared to men (42.1% vs. 21.7%; p: 0.0021 and 51.1% vs. 34.9%; p: 0.02), but severe depression was similar between genders (9.0% vs. 4.8%; p: 0.29). Significantly more patients had depression and anxiety than recorded in their charts (34.3% vs. 13.9% and 44.9% vs. 9.3%, respectively; p<0.0001 for both). 69.0% of T2D patients had mild, 6.0% had moderate and none had severe cognitive dysfunction, respectively. Significantly more patients with depression and anxiety had mild and moderate cognitive impairment (p: 0.03 and p: 0.04, respectively). Conclusions: Patients with T2D had a high prevalence of comorbid depression, anxiety and cognitive impairment. Depression and anxiety were significantly more frequent in women. These conditions were under-evaluated and/or under-reported. Continue reading >>
Diabetes And Depression
Tweet According to NICE, people who are diagnosed with a chronic physical health problem such as diabetes are 3 times more likely to be diagnosed with depression than people without it. Depression can have a serious impact on a person's well being and their ability and motivation to self-manage their condition. Depression is the most common psychiatric disorder witnessed in the diabetes community. People with diabetes suffering from depression are at greater risk of suffering from an episode of diabetic burnout which collectively can have adverse effects on physical health and potentially instigate more long term complications both to do with diabetes and independent from the condition. What exactly is depression? Depression is the term given when an individual experiences a number of symptoms including: Persistent sadness or anxiety, a feeling of hollowness An overriding feeling of hopelessness and negativity Feeling helpless and powerless to change your situation Loss of interest in activities or pleasures Lower energy and increased fatigue Insomnia, oversleeping, awakening early in the morning Concentration problems, memory problems and indecisiveness Dwelling on death or suicide Restlessness Weight change and decreased or increased appetite A diagnosis of depression is made if many of these symptoms are present, continuously, for a minimum of two weeks. For people with diabetes, dealing with a lifelong condition and managing the risk of complications can seem like an overwhelming task, particularly for newly diagnosed patients. Many diabetics struggle to cope with the requirements, feeling overwhelmed and unmotivated. If diabetes is not faced with an attitude of perseverance and defiance, often depression will prevail. Depression is the perception of life situations Continue reading >>
High Levels Of Anxiety And Depression In Diabetic Patients With Charcot Foot
Abstract Background/aims Charcot foot is a rare but devastating complication of diabetes. Little research is available on the mental health impact of Charcot foot. Aim of the study is to assess mental health in diabetes patients with Charcot foot and to investigate the moderating effects of socio-demographic factors. The severity of the problem will be statistically evaluated with the help of a reference data set. Cross-sectional questionnaire data using the Hospital Anxiety and Depression Scale (HADS) and demographic background were collected from 50 patients with diabetes and Charcot complications (males 62%; mean age 62.2 ± 8.5 years). Statistical comparisons with a large data set of general diabetes patients acting as a point of reference were carried out. Anxiety and depression levels were high, (anxiety and depression scores 6.4 ± 4 and 6.3 ± 3.6 respectively). Females reported more severe anxiety and depression. Ethnic minorities and patients out of work reported more severe anxiety. Comparisons with published HADS data indicate that diabetes patients with Charcot foot experience more serious levels of anxiety and depression. The high levels of mental health problems which were found in this study in diabetes patients with Charcot foot require recognition by researchers and clinicians. The findings imply the need to screen for mental health problems in diabetes patients with Charcot foot. Notes The data reported in this paper were collected as part of the MSc Dissertation by the first author (MSc Diabetes, University of Roehampton, London). The authors would like to thank and acknowledge the help and support of Professor Michael Edmonds, Professor William Jeffcoate, Pradeep Solanki, Reginald Grant and also the colleagues at King’s College Hospital Diabetic F Continue reading >>
