Document Type : Original Article


1 Department of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

2 College of Nursing, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

3 Department of Dermatology, Government Doon Medical College, Dehradun, Uttarakhand, India

4 Department of Psychiatry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

5 Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India


BACKGROUND: Type 2 diabetes mellitus (DM) is a multifactorial disease and can be described as a
noncommunicable disease of epidemic magnitude. Little is known about the predictors of depression
in this population, especially among the Indian population. This study explores the predictors for
depression in patients with type 2 DM.
MATERIALS AND METHODS: A cross‑sectional study was performed for a period of 7 months
during 2018–2019. The data were collected from 250 subjects at the diabetic clinic and psychiatry
outpatient department of a tertiary care teaching hospital. T2DM with an age group of 18–60 years
were included. Exclusion criteria were clinical evidence of any significant Axis I psychiatric disorder
according to the International Classification of Diseases‑10 Diagnostic Criteria for Research other
than depression and substance use disorders. Data were analyzed with multiple linear regression
analysis using SPSS‑23 version.
RESULTS: Male and female patients were 127 (50.80%) and 123 (49.20%), respectively. The
prevalence of depression was 49.20% among 250 patients with T2DM. Female patients had higher
depression than male patients. We found age (P = 0.013), female gender (P = 0.041), locality of the
patient (P = 0.021), body mass index (BMI) (P = 0.018), and fasting blood sugar (FBS) (P = 0.045)
as significant predictors of depression among T2DM patients.
CONCLUSIONS: The study concludes that females and elderly patients were more affected by
depression. The predictors of depression were age, gender, locality, BMI, and FBS among diabetic
patients. The findings indicate to screen the patients of T2DM for depression, predominantly female
and elderly patients, at regular intervals as per clinical demand.


1. van der Donk LJ, Fleer J, Sanderman R, Emmelkamp PM, Links TP,
Tovote KA, et al. Is type of depressive symptoms associated
with patient-perceived need for professional psychological
care in depressed individuals with diabetes? PLoS One.
2019 Feb 14;14(2):e0212304.
2. Bădescu SV, Tătaru C, Kobylinska L, Georgescu EL, Zahiu DM,
Zăgrean AM, et al. The association between diabetes mellitus and
depression. J Med Life 2016;9:120‑5.
3. Naskar S, Victor R, Nath K. Depression in diabetes mellitus – A
comprehensive systematic review of literature from an Indian
perspective. Asian J Psychiatr 2017;27:85‑100.
4. Tol A, Baghbanian A, Mohebbi B, Shojaeizadeh D, Azam K,
Shahmirzadi SE, et al. Empowerment assessment and influential
factors among patients with type 2 diabetes. J Diabetes Metab
Disord 2013;12:6.
5. Tol A, Pourreza A, Shojaeezadeh D, Mahmoodi M, Mohebbi B.
The assessment of relations between socioeconomic status and
number of complications among type 2 diabetic patients. Iran J
Public Health 2012;41:66‑72.
6. Mohebbi B, Tol A, Sadeghi R, Mohtarami SF, Shamshiri A.
Self‑management intervention program based on the Health Belief
Model (HBM) among women with gestational diabetes mellitus:
A quasi‑experimental study. Arch Iran Med 2019;22:168‑73.
7. van Dijk SE, Adriaanse MC, van der Zwaan L, Bosmans JE,
van Marwijk HW, van Tulder MW, et al. Measurement
properties of depression questionnaires in patients with diabetes:
A systematic review. Qual Life Res 2018;27:1415‑30.
8. Iype T, Shaji SK, Balakrishnan A, Charles D, Varghese AA,
Antony TP. Cognition in type 2 diabetes: Association with
vascular risk factors, complications of diabetes and depression.
Ann Indian Acad Neurol 2009;12:25‑7.
9. Singh H, Raju MS, Dubey V, Kurrey R, Bansal S, Malik M.
A study of sociodemographic clinical and glycemic control factors
associated with co‑morbid depression in type 2 diabetes mellitus.
Ind Psychiatry J 2014;23:134‑42.
10. Alzahrani A, Alghamdi A, Alqarni T, Alshareef R, Alzahrani A.
Prevalence and predictors of depression, anxiety, and stress
symptoms among patients with type II diabetes attending
primary healthcare centers in the western region of Saudi Arabia:
A cross‑sectional study. Int J Ment Health Syst 2019;13:48.
11. Rajput R, Gehlawat P, Gehlan D, Gupta R, Rajput M. Prevalence
and predictors of depression and anxiety in patients of diabetes
mellitus in a tertiary care center. Indian J Endocrinol Metab
12. Kamrul‑Hasan AB, Palash‑Molla M, Mainul‑Ahsan M, Gaffar AJ,
Asaduzzaman M, Saifuddin M, et al. Prevalence and predictors
of depression among patients with type 2 diabetes: A multicenter cross‑sectional study from Bangladesh. Mymensingh Med J
13. Gahlan D, Rajput R, Gehlawat P, Gupta R. Prevalence and
determinants of diabetes distress in patients of diabetes mellitus
in a tertiary care centre. Diabetes Metab Syndr 2018;12:333‑6.
14. Khullar S, Dhillon H, Kaur G, Sharma R, Mehta K, Aggarwal R,
et al. The prevalence and predictors of depression in type 2 diabetic
population of Punjab. Community Ment Health J 2016;52:479‑83.
15. Bahety P, Agarwal G, Khandelwal D, Dutta D, Kalra S, Taparia P,
et al. Occurrence and predictors of depression and poor quality
of life among patients with type‑2 diabetes: A northern India
perspective. Indian J Endocrinol Metab 2017;21:564‑9.
16. Dhanaraj E, Raval A, Yadav R, Bhansali A, Tiwari P. Prescription
Pattern of Antihypertensive Agents in T2DM Patients
Visiting Tertiary Care Centre in North India. Int J Hypertens.
17. Madhu M, Abish A, Anu K, Jophin RI, Kiran AM, Vijayakumar K.
Predictors of depression among patients with diabetes mellitus
in Southern India. Asian J Psychiatr 2013;6:313‑7.
18. Chowdhury SH, Karim MN, Selim S, Ahmed F ,
Azad AK, Maksud SA, et al. Risk of depression among
Bangladeshi type 2 diabetic patients. Diabetes Metab Syndr
2017;11 Suppl 2:S1009‑12.
19. Chen F, Wei G, Wang Y, Liu T, Huang T, Wei Q, et al. Risk
factors for depression in elderly diabetic patients and the effect
of metformin on the condition. BMC Public Health 2019;19:1063.
20. Tol A, Shojaeezadeh D, Eslami A, Alhani F, Mohajeritehrani M,
Baghbanian A, et al. Evaluation of self‑care practices and relative
components among type 2 diabetic patients. J Educ Health Promot
21. Zanjani S, Tol A, Mohebbi B, Sadeghi R, Jalyani KN, Moradi A.
Determinants of healthy lifestyle and its related factors among
elderly people. J Educ Health Promot 2015;4:103.
22. Simayi A, Mohemaiti P. Risk and protective factors of co‑morbid
depression in patients with type 2 diabetes mellitus: A meta
analysis. Endocr J 2019;66:793‑805.
23. Khaledi M, Haghighatdoost F, Feizi A, Aminorroaya A. The
prevalence of comorbid depression in patients with type 2
diabetes: An updated systematic review and meta‑analysis
on huge number of observational studies. Acta Diabetol
24. Shrestha M, Al‑Ghareeb A, Alenazi F, Gray R. Association
between subthreshold depression and self‑care behaviour in
people with type 2 diabetes: A protocol for systematic review of
observational studies. Syst Rev 2019;8:167.
25. Babazadeh T, Dianatinasab M, Daemi A, Nikbakht HA, Moradi F,
Ghaffari‑Fam S. Association of self‑care behaviors and quality
of life among patients with type 2 diabetes mellitus: Chaldoran
county, Iran. Diabetes Metab J 2017;41:449‑56.
26. Kant R, Yadav P, Kishore S. Gender diversity of insulin sensitivity
markers among patients of type 2 diabetes mellitus in northern
India: A cross‑sectional analytical study. J Family Med Prim Care
27. Katon WJ, Lin EH, Russo J, Von Korff M, Ciechanowski P,
Simon G, et al. Cardiac risk factors in patients with diabetes
mellitus and major depression. J Gen Intern Med 2004;19:1192‑9.