[Biological factors associated with depression in patients with type ΙΙ diabetes mellitus]

This study was undertaken in order to identify the prevalence and factors associated with depression in a group of patients with type II diabetes mellitus. 200 patients (127 women/73 men) with type II diabetes mellitus, from Diabetic Clinic of 1st Propedeutic Medical Department of Aristotle's University of Thessaloniki, AHEPA Hospital, were enrolled in our study. Patients, sex, age, duration of diabetes, antidiabetic treatment, diabetic complications, body mass index (BMI), waist circumference, blood pressure, smoking, physical exercise and alcohol intake were assessed. BDI-II(Beck Depression Inventory-II) scale was used to measure the presence of depression. Prevalence of depression was high in the total of our patients (31.5%) and also in men (26%) and women (34.6%) separately. Depression appeared not to be related to patients' age, duration of diabetes, smokingand physical exercise, in the total of them (p>0.05). Patients, who were prescribed insulin, seemed to be more often depressed compared to those undertaking oral antidiabetic medication. The presence of depression was statistically significant increased in patients with diabetic complicationsin the total (p=0.013) and in men (p=0.001), while it was almost significantly increased in patients with diabetic nephropathy (p=0.052) and stroke (p=0.097). Depression was statistically significant related to obese patients compared to normal weight patients, in the total (p=0.003), and in menseparately (p=0.013), and also statistically significant was the relationship of depression with central obesity in the total (p=0.011) and in men (p=0.014). Statistically important was the relationship of arterial hypertension with depression in diabetic men (p=0.030), while in the limits of statistical importance was the relationship between depression and modest to heavy alcohol consumption in women (p=0.063). In a clinical aspect, depression seems to influence the development of type II diabetes mellitus, as it is shown by the significant association of diabetic complications anddepressive symptoms. The development of depression has often been considered a secondary response to the onset of complications, but depression might also play a primary role in the development or exacerbation of diabetic complications. It would be reasonable to speculate that obesity and arterial hypertension are biological variables that may interact with depression to produce diabetic complications. Further studies are needed to identify the pathways that mediate this association. These observations demonstrate that depression has a significant role in the development of type II diabetes mellitus, implying the necessity of its diagnosis and treatment, for the most optimal confrontation of the diabetic patient.