Prevalence and Clinical Correlators of Undiagnosed Significant Depressive Symptoms Among Individuals with Type 2 Diabetes In A Mediterranean Population

Objective: To determine the frequency and clinical parameters, of clinically significant depressive symptoms among a type 2 diabetes (T2DM) sample from a Mediterranean area without an established diagnosis of depressive disorder (DD). Methods: 320 subjects with T2DM were recruited randomly from Primary-Care settings and the Endocrine Department from a tertiary center in Mallorca (Spain). 91 healthy individuals matched by age, gender and BMI were used as controls. All participating patients graded by the presence of DD by using the "Beck Depression Inventory" (BDI), considering pathological a cut-off score equal or greater than 16. Results: 27.2 % T2DM subjects had significant symptoms of DD compared with 12.1 % in the control group (p < 0.01). BDI score was higher among T2DM when compared with controls (12 +/- 9.6 vs. 7.4 +/- 5, p < 0.0001). The proportion of females (68 % vs. 37 %, p < 0.0001), subjects without an active job (68 % vs. 45 %, p = 0.01) and singles (38 % vs. 18 %, p = 0.007) was greater among T2DM with a BDI = 16. Subjects with criteria for DD had a higher BMI (31.99 +/- 5.96 vs. 30.53 +/- 5.62, p = 0.03). Fasting plasma glucose was higher among T2DM with a BDI = 16 (162 +/- 70 vs. 147 +/- 45 mg/dl, p = 0.02) as well as HbA1c levels (7.9 +/- 1.8 % vs. 7.4 +/- 1.4 %, p = 0.01), triglycerides (203 +/- 183 vs. 161 +/- 103 mg/dl; p = 0.03) and LDL-cholesterol (112 +/- 31 vs. 104 +/- 35 mg/dl; p = 0.03). Gender, marital status, BMI and triglycerides were independently related to the presence of DD after a logistic regression model. Conclusions: Relevant depressive symptoms are more prevalent among Mediterranean T2DM subjects than in general population. Main clinical correlators of significant depressive symptoms are gender, marital status and BMI.