Patients with diabetes should be screened for depression to lower threats from both

Patients with diabetes are more than six times likely to suffer from depression than patients without diabetes, finds a new icddr,b study examining the coexistence of the two health conditions in Bangladesh.

The study calls for routine screening for depression in patients with diabetes in the country because of the heightened commonness of the two conditions existing at the same time, and because appropriate treatment for one could lead to lowering the risk from the other.

Two more revealing facts are that depression is often unrecognised and untreated in approximately two–thirds of patients in primary care settings, and that the prevalence of both diabetes and depression are increasing in Southeast Asia.

Photo by: Trinity Care Foundation. CC BY-NC-ND 2.0

The new matched case–control study by icddr,b researchers and international colleagues, published recently in the Journal of Global Health, looked at 591 patients with diabetes and 591 patients without diabetes matched for age, sex and area of residence, aiming to find out whether the persons with diabetes would have higher prevalence of depression than persons without diabetes.

The high prevalence of moderate to severe depression amongst the patients with diabetes they found confirmed findings from earlier studies conducted in Bangladesh that showed type 2 diabetes to be associated with an increased risk of depressive symptoms.

Nevertheless, why are these findings significant for patients in Bangladesh whereas earlier findings have already underscored the twofold risk?

Screening patients with diabetes who are at high risk of developing depression should lead to appropriate treatment for lowering depression, which, in turn, is expected to facilitate increased medication adherence and physical activity and help improve diabetes and its complications, says Dr Shariful Islam, a senior research investigator at icddr,b and postdoctoral research fellow at the George Institute for Global Health, University of Sydney, Australia.

The study points out that the limited workforce in mental healthcare in Bangladesh makes patients with diabetes and depression less likely to receive adequate management for both conditions.

The recommended routine screening thus might be a cost-effective intervention in our setting, adds Dr Islam.

Findings also indicate that the association of diabetes and depression was independent of an individual’s education and household income, and was not affected by other socio–demographic factors, body mass index, hypertension, or the number of diabetes–associated complications.

Therefore, patients with diabetes from all walks of life have adequate reasons to be concerned.

The study was funded by icddr,b’s core Sida Grant with support from the Center for International Health (CIH), Ludwig–Maximilians– Universität (LMU) in Munich, Germany, German Academic Exchange Service (DAAD), Federal Ministry for Economic Cooperation and Development (BMZ).