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Lifestyle
Enhancing Diabetes Care through a Mobile Application: A Randomized Clinical Trial on Integrating Physical and Mental Health among Disadvantaged Individuals
Jae Hyun Bae, Eun Hee Park, Hae Kyung Lee, Kun Ho Yoon, Kyu Chang Won, Hyun Mi Kim, Sin Gon Kim
Received August 24, 2023  Accepted October 16, 2023  Published online February 2, 2024  
DOI: https://doi.org/10.4093/dmj.2023.0298    [Epub ahead of print]
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Background
This study examines integrating physical and mental healthcare for disadvantaged persons with type 2 diabetes mellitus and mild-to-moderate depression in the community, using a mobile application within a public-private-academic partnership.
Methods
The Korean Diabetes Association has developed a mobile application combining behavioral activation for psychological well-being and diabetes self-management, with conventional medical therapy. Participants were randomly assigned to receive the application with usual care or only usual care. Primary outcomes measured changes in psychological status and diabetes selfmanagement through questionnaires at week 12 from the baseline. Secondary outcomes assessed glycemic and lipid control, with psychological assessments at week 16.
Results
Thirty-nine of 73 participants completed the study (20 and 19 in the intervention and control groups, respectively) and were included in the analysis. At week 12, the intervention group showed significant reductions in depression severity and perceived stress compared to the control group. Additionally, they reported increased perceived social support and demonstrated improved diabetes self-care behavior. These positive effects persisted through week 16, with the added benefit of reduced anxiety. While fasting glucose levels in the intervention group tended to improve, no other significant differences were observed in laboratory assessments between the groups.
Conclusion
This study provides compelling evidence for the potential efficacy of a mobile application that integrates physical and mental health components to address depressive symptoms and enhance diabetes self-management in disadvantaged individuals with type 2 diabetes mellitus and depression. Further research involving larger and more diverse populations is warranted to validate these findings and solidify their implications.
Complications
Risk of Depression according to Cumulative Exposure to a Low-Household Income Status in Individuals with Type 2 Diabetes Mellitus: A Nationwide Population- Based Study
So Hee Park, You-Bin Lee, Kyu-na Lee, Bongsung Kim, So Hyun Cho, So Yoon Kwon, Jiyun Park, Gyuri Kim, Sang-Man Jin, Kyu Yeon Hur, Kyungdo Han, Jae Hyeon Kim
Diabetes Metab J. 2024;48(2):290-301.   Published online January 3, 2024
DOI: https://doi.org/10.4093/dmj.2022.0299
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
We aimed to identify the risk of incident depression according to cumulative exposure to a low-household income status in individuals with type 2 diabetes mellitus (T2DM).
Methods
For this retrospective longitudinal population-based cohort study, we used Korean National Health Insurance Service data from 2002 to 2018. Risk of depression was assessed according to cumulative exposure to low-household income status (defined as Medical Aid registration) during the previous 5 years among adults (aged ≥20 years) with T2DM and without baseline depression who underwent health examinations from 2009 to 2012 (n=2,027,317).
Results
During an average 6.23 years of follow-up, 401,175 incident depression cases occurred. Advance in cumulative number of years registered for medical aid during the previous 5 years from baseline was associated with an increased risk of depression in a dose-dependent manner (hazard ratio [HR], 1.44 [95% confidence interval (CI), 1.38 to 1.50]; HR, 1.40 [95% CI, 1.35 to 1.46]; HR, 1.42, [95% CI, 1.37 to 1.48]; HR, 1.46, [95% CI, 1.40 to 1.53]; HR, 1.69, [95% CI, 1.63 to 1.74] in groups with 1 to 5 exposed years, respectively). Insulin users exposed for 5 years to a low-household income state had the highest risk of depression among groups categorized by insulin use and duration of low-household income status.
Conclusion
Cumulative duration of low-household income status, defined as medical aid registration, was associated with an increased risk of depression in a dose-response manner in individuals with T2DM.
Cardiovascular risk/Epidemiology
Increased Risk of Cardiovascular Disease and Mortality in Patients with Diabetes and Coexisting Depression: A Nationwide Population-Based Cohort Study
Inha Jung, Hyemi Kwon, Se Eun Park, Kyung-Do Han, Yong-Gyu Park, Yang-Hyun Kim, Eun-Jung Rhee, Won-Young Lee
Diabetes Metab J. 2021;45(3):379-389.   Published online December 11, 2020
DOI: https://doi.org/10.4093/dmj.2020.0008
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  • 22 Web of Science
  • 21 Crossref
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Previous studies have suggested that depression in patients with diabetes is associated with worse health outcomes. The aim of this study was to evaluate the risk of cardiovascular disease (CVD) and mortality in patients with diabetes with comorbid depression.
Methods
We examined the general health check-up data and claim database of the Korean National Health Insurance Service (NHIS) of 2,668,615 participants with type 2 diabetes mellitus who had examinations between 2009 and 2012. As NHIS database has been established since 2002, those who had been diagnosed with depression or CVD since 2002 were excluded. The 2,228,443 participants were classified into three groups according to the claim history of depression; normal group (n=2,166,979), transient depression group (one episode of depression, n=42,124) and persistent depression group (at least two episodes of depression, n=19,340). The development of CVD and mortality were analyzed from 2009 to 2017.
Results
Those with depression showed a significantly increased risk for stroke (transient depression group: hazard ratio [HR], 1.20; 95% confidence interval [CI], 1.15 to 1.26) (persistent depression group: HR, 1.54; 95% CI, 1.46 to 1.63). Those with depression had an increased risk for myocardial infarction (transient depression group: HR, 1.25; 95% CI, 1.18 to 1.31) (persistent depression group: HR, 1.38; 95% CI, 1.29 to 1.49). The persistent depression group had an increased risk for all-cause mortality (HR, 1.66; 95% CI, 1.60 to 1.72).
Conclusion
Coexisting depression in patients with diabetes has a deleterious effect on the development of CVD and mortality. We suggest that more attention should be given to patients with diabetes who present with depressive symptoms.

Citations

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  • Psychological resilience mediates the relationship between diabetes distress and depression among persons with diabetes in a multi-group analysis
    Ajele Kenni Wojujutari, Erhabor Sunday Idemudia, Lawrence Ejike Ugwu
    Scientific Reports.2024;[Epub]     CrossRef
  • The mediating effect of depression on new-onset stroke in diabetic population: Evidence from the China health and retirement longitudinal study
    Gege Jiang, Yaoling Wang, Liping Wang, Minfang Chen, Wei Li
    Journal of Affective Disorders.2023; 321: 208.     CrossRef
  • Frailty and outcomes in lacunar stroke
    Sima Vazquez, Zehavya Stadlan, Justin M Lapow, Eric Feldstein, Smit Shah, Ankita Das, Alexandria F Naftchi, Eris Spirollari, Akash Thaker, Syed Faraz Kazim, Jose F Dominguez, Neisha Patel, Christeena Kurian, Ji Chong, Stephan A Mayer, Gurmeen Kaur, Chirag
    Journal of Stroke and Cerebrovascular Diseases.2023; 32(2): 106942.     CrossRef
  • Comparison of Operational Definition of Type 2 Diabetes Mellitus Based on Data from Korean National Health Insurance Service and Korea National Health and Nutrition Examination Survey
    Jong Ha Baek, Yong-Moon Park, Kyung Do Han, Min Kyong Moon, Jong Han Choi, Seung-Hyun Ko
    Diabetes & Metabolism Journal.2023; 47(2): 201.     CrossRef
  • The Association between Dietary Carotenoid Intake and Risk of Depression among Patients with Cardiometabolic Disease
    Jie Liang, Yuhao Wang, Min Chen
    International Heart Journal.2023; 64(2): 223.     CrossRef
  • Associations of concomitant retinopathy and depression with mortality in a nationally representative population
    Zheng Lyu, Yilin Chen, Zhuoting Zhu, Xiaoyang Luo, Ying Cui, Jie Xie, Zhifan Chen, Junbin Liu, Xiyu Wu, Gabrella Bulloch, Qianli Meng
    Journal of Affective Disorders.2023; 336: 15.     CrossRef
  • Clinical insights into the cross-link between mood disorders and type 2 diabetes: A review of longitudinal studies and Mendelian randomisation analyses
    Chiara Possidente, Giuseppe Fanelli, Alessandro Serretti, Chiara Fabbri
    Neuroscience & Biobehavioral Reviews.2023; 152: 105298.     CrossRef
  • Prevalence of depression and association with all-cause and cardiovascular mortality among individuals with type 2 diabetes: a cohort study based on NHANES 2005–2018 data
    Zhen Feng, Wai Kei Tong, Xinyue Zhang, Zhijia Tang
    BMC Psychiatry.2023;[Epub]     CrossRef
  • Cholecystectomy Increases the Risk of Type 2 Diabetes in the Korean Population
    Ji Hye Huh, Kyong Joo Lee, Yun Kyung Cho, Shinje Moon, Yoon Jung Kim, Eun Roh, Kyung-do Han, Dong Hee Koh, Jun Goo Kang, Seong Jin Lee, Sung-Hee Ihm
    Annals of Surgery.2023; 278(2): e264.     CrossRef
  • Risk of depression in patients with acromegaly in Korea (2006-2016): a nationwide population-based study
    Shinje Moon, Sangmo Hong, Kyungdo Han, Cheol-Young Park
    European Journal of Endocrinology.2023; 189(3): 363.     CrossRef
  • The association between cardiovascular drugs and depression/anxiety in patients with cardiovascular disease: A meta-analysis
    Lijun Zhang, Yanping Bao, Shuhui Tao, Yimiao Zhao, Meiyan Liu
    Pharmacological Research.2022; 175: 106024.     CrossRef
  • Association of mental health with the risk of coronary artery disease in patients with diabetes: A mendelian randomization study
    Teng Hu, Fangkun Yang, Kewan He, Jiajun Ying, Hanbin Cui
    Nutrition, Metabolism and Cardiovascular Diseases.2022; 32(3): 703.     CrossRef
  • Comorbidity of Type 2 Diabetes Mellitus and Depression: Clinical Evidence and Rationale for the Exacerbation of Cardiovascular Disease
    Mengmeng Zhu, Yiwen Li, Binyu Luo, Jing Cui, Yanfei Liu, Yue Liu
    Frontiers in Cardiovascular Medicine.2022;[Epub]     CrossRef
  • Understanding and Utilizing Claim Data from the Korean National Health Insurance Service (NHIS) and Health Insurance Review & Assessment (HIRA) Database for Research
    Dae-Sung Kyoung, Hun-Sung Kim
    Journal of Lipid and Atherosclerosis.2022; 11(2): 103.     CrossRef
  • Evaluating Triglyceride and Glucose Index as a Simple and Easy-to-Calculate Marker for All-Cause and Cardiovascular Mortality
    Kyung-Soo Kim, Sangmo Hong, You-Cheol Hwang, Hong-Yup Ahn, Cheol-Young Park
    Journal of General Internal Medicine.2022; 37(16): 4153.     CrossRef
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    Himanshu Verma, Anindita Bhattacharjee, Naveen Shivavedi, Prasanta Kumar Nayak
    Naunyn-Schmiedeberg's Archives of Pharmacology.2022; 395(10): 1189.     CrossRef
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    Mee Kyoung Kim, Kyungdo Han, Hun-Sung Kim, Kun-Ho Yoon, Seung-Hwan Lee
    European Journal of Preventive Cardiology.2022; 29(14): 1866.     CrossRef
  • Risk factors associated with mortality among individuals with type 2 diabetes and depression across two cohorts
    Christopher Rohde, Jens Steen Nielsen, Jakob Schöllhammer Knudsen, Reimar Wernich Thomsen, Søren Dinesen Østergaard
    European Journal of Endocrinology.2022; 187(4): 567.     CrossRef
  • Increased Risk of Cardiovascular Disease and Mortality in Patients with Diabetes and Coexisting Depression: A Nationwide Population-Based Cohort Study (Diabetes Metab J 2021;45:379-89)
    Jin Hwa Kim
    Diabetes & Metabolism Journal.2021; 45(5): 789.     CrossRef
  • Increased Risk of Cardiovascular Disease and Mortality in Patients with Diabetes and Coexisting Depression: A Nationwide Population-Based Cohort Study (Diabetes Metab J 2021;45:379-89)
    Inha Jung, Eun-Jung Rhee, Won-Young Lee
    Diabetes & Metabolism Journal.2021; 45(5): 793.     CrossRef
  • Affective Temperament and Glycemic Control – The Psychological Aspect of Obesity and Diabetes Mellitus
    Natalia Lesiewska, Anna Kamińska, Roman Junik, Magdalena Michalewicz, Bartłomiej Myszkowski, Alina Borkowska, Maciej Bieliński
    Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2021; Volume 14: 4981.     CrossRef
Lifestyle
Persistent Anxiety Is Associated with Higher Glycemia Post-Transition to Adult Services in Asian Young Adults with Diabetes
Ling Zhu, Suresh Rama Chandran, Wee Boon Tan, Xiaohui Xin, Su-Yen Goh, Daphne Su-Lyn Gardner
Diabetes Metab J. 2021;45(1):67-76.   Published online June 15, 2020
DOI: https://doi.org/10.4093/dmj.2019.0226
  • 5,479 View
  • 106 Download
  • 5 Web of Science
  • 6 Crossref
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background

There is little longitudinal information on psychological burden and metabolic outcomes in young adults with diabetes (YAD) in Asia. We aimed to evaluate the association between psychological status and glycemia at baseline and 2 years following transition in a cohort of YAD in Singapore.

Methods

Subjects with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM), aged 17 to 25 years, were recruited from the YAD clinic in Singapore General Hospital. The Hospital Anxiety and Depression and Problem Areas for Diabetes scales were administered at transition (baseline) and at 18 to 24 months. Glycosylated hemoglobin (HbA1c) assessed during routine visits was tracked longitudinally.

Results

A total of 98 T1DM (74.8%) and 33 T2DM (25.2%) subjects were recruited between January 2011 and November 2017. At baseline, mean HbA1c was 8.6%±1.7%. Only 26.0% achieved HbA1c of ≤7.5% and 16.8% achieved HbA1c of <7%. At baseline, prevalence of anxiety was 29.8%. At 24 months, 14.1% had persistent anxiety. Those with persistent anxiety had the highest mean HbA1c, particularly at 6 months (persistently anxious vs. persistently non-anxious: 9.9%±1.2% vs. 8.2%±1.9%, P=0.009). At baseline, 9.2% of subjects had depression. This group also had poorer glycemia at baseline (HbA1c of depressed vs non-depressed: 9.6%±2.1% vs. 8.5%±1.6%, P=0.04), which persisted up to 24 months.

Conclusion

The majority of YAD in Singapore have suboptimal glycemia. Psychological distress is a critical harbinger of poorer metabolic outcomes.

Citations

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  • The Cost-Effectiveness of an Advanced Hybrid Closed-Loop System Compared to Standard Management of Type 1 Diabetes in a Singapore Setting
    Daphne Gardner, Mrinmayee Lakkad, Zhiyu Qiu, Yuta Inoue, Suresh Rama Chandran, Kael Wherry
    Diabetes Technology & Therapeutics.2024; 26(5): 324.     CrossRef
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Cardiovascular Risk/Epidemiology
Pre-existing Depression among Newly Diagnosed Dyslipidemia Patients and Cardiovascular Disease Risk
Jihoon Andrew Kim, Seulggie Choi, Daein Choi, Sang Min Park
Diabetes Metab J. 2020;44(2):307-315.   Published online November 1, 2019
DOI: https://doi.org/10.4093/dmj.2019.0002
  • 5,335 View
  • 89 Download
  • 9 Web of Science
  • 8 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   
Background

Whether depression before diagnosis of dyslipidemia is associated with higher cardiovascular disease (CVD) risk among newly diagnosed dyslipidemia patients is yet unclear.

Methods

The study population consisted of 72,235 newly diagnosed dyslipidemia patients during 2003 to 2012 from the National Health Insurance Service–Health Screening Cohort of South Korea. Newly diagnosed dyslipidemia patients were then detected for pre-existing depression within 3 years before dyslipidemia diagnosis. Starting from 2 years after the diagnosis date, patients were followed up for CVD until 2015. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for CVD were calculated by Cox proportional hazards regression.

Results

Compared to dyslipidemia patients without depression, those with depression had higher risk for CVD (aHR, 1.24; 95% CI, 1.09 to 1.41). Similarly, pre-existing depression was associated with increased risk for stroke (aHR, 1.27; 95% CI, 1.06 to 1.53). The risk for CVD among depressed dyslipidemia patients for high (aHR, 1.42; 95% CI, 1.06 to 1.90), medium (aHR, 1.17; 95% CI, 0.91 to 1.52), and low (aHR, 1.25; 95% CI, 1.05 to 1.50) statin compliance patients tended to be increased compared to patients without pre-existing dyslipidemia. The risk-elevating effect of depression on CVD tended to be preserved regardless of subgroups of smoking, alcohol consumption, physical activity, and body mass index.

Conclusion

Dyslipidemia patients with pre-existing depression had increased risk for CVD. Future studies that determine CVD risk after management of depression among dyslipidemia patients are needed.

Citations

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Review
Clinical Diabetes & Therapeutics
Past and Current Status of Adult Type 2 Diabetes Mellitus Management in Korea: A National Health Insurance Service Database Analysis
Seung-Hyun Ko, Kyungdo Han, Yong-ho Lee, Junghyun Noh, Cheol-Young Park, Dae-Jung Kim, Chang Hee Jung, Ki-Up Lee, Kyung-Soo Ko
Diabetes Metab J. 2018;42(2):93-100.   Published online April 19, 2018
DOI: https://doi.org/10.4093/dmj.2018.42.2.93
  • 8,482 View
  • 148 Download
  • 82 Web of Science
  • 83 Crossref
AbstractAbstract PDFPubReader   

Korea's National Healthcare Program, the National Health Insurance Service (NHIS), a government-affiliated agency under the Korean Ministry of Health and Welfare, covers the entire Korean population. The NHIS supervises all medical services in Korea and establishes a systematic National Health Information database (DB). A health information DB system including all of the claims, medications, death information, and health check-ups, both in the general population and in patients with various diseases, is not common worldwide. On June 9, 2014, the NHIS signed a memorandum of understanding with the Korean Diabetes Association (KDA) to provide limited open access to its DB. By October 31, 2017, seven papers had been published through this collaborative research project. These studies were conducted to investigate the past and current status of type 2 diabetes mellitus and its complications and management in Korea. This review is a brief summary of the collaborative projects between the KDA and the NHIS over the last 3 years. According to the analysis, the national health check-up DB or claim DB were used, and the age category or study period were differentially applied.

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Original Articles
Clinical Care/Education
Depressive Symptoms Are Negatively Associated with Glucose Testing and Eating Meals on Time among Individuals with Diabetes in Zambia
Given Hapunda, Amina Abubakar, Frans Pouwer, Fons van de Vijver
Diabetes Metab J. 2017;41(6):440-448.   Published online November 17, 2017
DOI: https://doi.org/10.4093/dmj.2017.41.6.440
  • 3,646 View
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AbstractAbstract PDFPubReader   
Background

Depression is an established risk factor for cardiovascular diseases and mortality among individuals living with diabetes, and impaired self-care behaviors may play a mediating role. In Africa, this association is not very well known. In this study, we examined the associations between depressive symptoms and different aspects of diabetes self-care in Zambian individuals with diabetes mellitus.

Methods

A total of 157 individuals with diabetes mellitus participated. The sample was drawn from four city hospitals in Zambia. Diabetes self-care was assessed using the diabetes self-care inventory, and depression was assessed using the major depression inventory.

Results

Fifty-nine percent of the sample had type 1 diabetes mellitus. Variations in self-care activities and behaviors were reported as least adhered to by individuals with type 1 and type 2 diabetes mellitus, in adolescent and adult patients. Regression analysis indicated that there was no association between total diabetes self-care and the depression total score. However, depression was associated with poor glucose testing and not eating meals on time by patients with diabetes.

Conclusion

Some variance on poor self-care was explained by demographic characteristics, specifically age, body mass index, and to some extent, socioeconomic status. Recognition and successful treatment of depression in patients with diabetes might help to optimize self-care behaviors, especially glucose testing and eating meals on time. However, this hypothesis needs further testing.

Citations

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  • Self-management practices for preventing complications of type II diabetes mellitus in low and middle-income countries: A scoping review
    Pauline Muthoni Maina, Melanie Pienaar, Marianne Reid
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Clinical Care/Education
The Role of Negative Affect in the Assessment of Quality of Life among Women with Type 1 Diabetes Mellitus
Nicola R. Gawlik, Malcolm J. Bond
Diabetes Metab J. 2018;42(2):130-136.   Published online November 7, 2017
DOI: https://doi.org/10.4093/dmj.2018.42.2.130
  • 3,623 View
  • 33 Download
  • 2 Web of Science
  • 4 Crossref
AbstractAbstract PDFPubReader   
Background

The purpose of this study is to determine the impact of negative affect (defined in terms of lack of optimism, depressogenic attributional style, and hopelessness depression) on the quality of life of women with type 1 diabetes mellitus.

Methods

Participants (n=177) completed either an online or paper questionnaire made available to members of Australian diabetes support groups. Measures of optimism, attributional style, hopelessness depression, disease-specific data, and diabetes-related quality of life were sought. Bivariate correlations informed the construction of a structural equation model.

Results

Participants were 36.3±11.3 years old, with a disease duration of 18.4±11.2 years. Age and recent glycosylated hemoglobin readings were significant contextual variables in the model. All bivariate associations involving the components of negative affect were as hypothesized. That is, poorer quality of life was associated with a greater depressogenic attributional style, higher hopelessness depression, and lower optimism. The structural equation model demonstrated significant direct effects of depressogenic attributional style and hopelessness depression on quality of life, while (lack of) optimism contributed to quality of life indirectly by way of these variables.

Conclusion

The recognition of negative affect presentations among patients, and an understanding of its relevance to diabetes-related quality of life, is a valuable tool for the practitioner.

Citations

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  • Menopoz dönemindeki diyabetik kadınlarda yaşanılan semptomların yaşam kalitesi parametreleri üzerindeki etkisinin incelenmesi (Prospektif Tek Grup Çalışma)
    Ayşegül KOÇ, Betül ÇAKMAK, Birgül GENÇ
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    Eun Chong Shin
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    Minerva Granado-Casas, Esmeralda Castelblanco, Anna Ramírez-Morros, Mariona Martín, Nuria Alcubierre, Montserrat Martínez-Alonso, Xavier Valldeperas, Alicia Traveset, Esther Rubinat, Ana Lucas-Martin, Marta Hernández, Núria Alonso, Didac Mauricio
    Journal of Clinical Medicine.2019; 8(3): 377.     CrossRef
  • Is Diabetes & Metabolism Journal Eligible to Be Indexed in MEDLINE?
    Sun Huh
    Diabetes & Metabolism Journal.2018; 42(6): 472.     CrossRef
Epidemiology
Depression and Mortality in People with Type 2 Diabetes Mellitus, 2003 to 2013: A Nationwide Population-Based Cohort Study
Jong-Hyun Jeong, Yoo Hyun Um, Seung-Hyun Ko, Jong-Heon Park, Joong-Yeol Park, Kyungdo Han, Kyung-Soo Ko
Diabetes Metab J. 2017;41(4):296-302.   Published online August 3, 2017
DOI: https://doi.org/10.4093/dmj.2017.41.4.296
  • 4,207 View
  • 54 Download
  • 23 Web of Science
  • 19 Crossref
AbstractAbstract PDFPubReader   
Background

Previous reports have demonstrated a bidirectional relationship between depression and diabetes mellitus (DM), accentuating a need for more intensive depression screening in DM patients. There is a relative paucity of data on the mortality of depressed DM patients in Korea.

Methods

Retrospective data from January 2003 to December 2013 were collected for adult type 2 diabetes mellitus (T2DM) patients older than 30 years using the National Health Information database maintained by the Korean National Health Insurance Service (NHIS). Demographic characteristics were analyzed with descriptive statistics, and the annual prevalence of depression was estimated. Mortality rates and hazard ratios for each age group (stratified into six age groups) of patients diagnosed with T2DM in 2003 were estimated using a Cox proportional hazard method, with the Kaplan-Meier cumulative survival curve showing the overall survival rates according to the T2DM status until the given year of 2013.

Results

The annual prevalence of depression was consistently higher in T2DM group from 2003 to 2013. The mortality hazard ratio was higher in the depressed in all age groups, and the risk was higher in male groups and in younger-aged groups.

Conclusion

Depression was significantly associated with a high mortality risk in T2DM patients; hence, a more systematic surveillance of T2DM patients to identify risk factors for depression might contribute significantly to reducing mortality risk in this group of patients.

Citations

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    Carlotta Lunghi, Arsène Zongo, Isabelle Tardif, Éric Demers, Joël Désiré Relwende Diendéré, Line Guénette
    Diabetes Research and Clinical Practice.2021; 171: 108566.     CrossRef
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    Cara Dochat, Jennalee S. Wooldridge, Matthew S. Herbert, Michael W. Lee, Niloofar Afari
    Journal of Contextual Behavioral Science.2021; 20: 52.     CrossRef
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    Jun Jie Benjamin Seng, Amelia Yuting Monteiro, Yu Heng Kwan, Sueziani Binte Zainudin, Chuen Seng Tan, Julian Thumboo, Lian Leng Low
    BMC Medical Research Methodology.2021;[Epub]     CrossRef
  • Increased Risk of Cardiovascular Disease and Mortality in Patients with Diabetes and Coexisting Depression: A Nationwide Population-Based Cohort Study
    Inha Jung, Hyemi Kwon, Se Eun Park, Kyung-Do Han, Yong-Gyu Park, Yang-Hyun Kim, Eun-Jung Rhee, Won-Young Lee
    Diabetes & Metabolism Journal.2021; 45(3): 379.     CrossRef
  • Spiritual intelligence, mindfulness, emotional dysregulation, depression relationship with mental well-being among persons with diabetes during COVID-19 pandemic
    Wojujutari Kenni Ajele, Teslim Alabi Oladejo, Abimbola A. Akanni, Oyeyemi Bukola Babalola
    Journal of Diabetes & Metabolic Disorders.2021; 20(2): 1705.     CrossRef
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    Seung-Hyun Ko, Kyungdo Han, Yong-ho Lee, Junghyun Noh, Cheol-Young Park, Dae-Jung Kim, Chang Hee Jung, Ki-Up Lee, Kyung-Soo Ko
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Prevalence of Depression and Glucose Abnormality in an Urbanizing Rural Population of Bangladesh
Khurshid Natasha, Akhtar Hussain, A. K. Azad Khan, Bishwajit Bhowmik
Diabetes Metab J. 2015;39(3):218-229.   Published online May 6, 2015
DOI: https://doi.org/10.4093/dmj.2015.39.3.218
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AbstractAbstract PDFPubReader   
Background

Depression and glucose abnormality are increasing in Bangladesh including its rural area. This study was designed to determine the prevalence of depression in an urbanizing rural population of Bangladesh with or without glucose abnormality (including diabetes mellitus [DM], and pre-diabetes which combines impaired fasting glucose and impaired glucose tolerance pre-DM).

Methods

A total of 2,293 subjects aged ≥20 years were investigated. Sociodemographic and anthropometric details, blood pressure, fasting (fasting plasma glucose) and 2 hours after 75 g plasma glucose (2-hour plasma glucose), were studied. Montgomery-Asberg Depression Rating Scale was used to assess depression.

Results

The overall prevalence of DM was 7.9% and pre-DM was 8.6%. Prevalence of depression was 15.31% (n=351; 95% confidence interval [CI], 1.59 to 1.36) with mean depressive score 17.62±3.49. Female were more likely to have depression (17.16%). The 22.35% of male and 29.46% of female with pre-DM and 26.58% male and 36.27% female with DM had depressive symptoms. There was no significant variation in the mean age of different groups (healthy, depressed and with glucose abnormality). Depression was significantly associated with age, marital status, occupation, high physical activity, and low body mass index. The odds ratio (OR) for depression was significantly increased in patients with glucose abnormality compared with those without pre-DM (OR, 2.49; 95% CI, 1.76 to 3.51; P<0.000) and DM (OR, 3.27; 95% CI, 2.33 to 4.60; P<0.000).

Conclusion

Prevalence of depression found alarming in our study area though lesser than previous studies and it is significantly related to glucose abnormality. The study reveals that mental health should get more focused specially along with metabolic diseases.

Citations

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  • Early-diagnosis of major depressive disorder: From biomarkers to point-of-care testing
    Xin Zhang, Zhiheng Zhang, Weize Diao, Chuangxin Zhou, Yetong Song, Renzhi Wang, Xiaoguang Luo, Guozhen Liu
    TrAC Trends in Analytical Chemistry.2023; 159: 116904.     CrossRef
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    Yukang Tan, Chunguo Zhang, Chaohua Tang, Zhijian Li, Wensheng Chen, Huan Jing, Wenting Liang, Xiaoling Li, Guojun Xie, Jiaquan Liang, Huagui Guo
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  • Elevated depressive symptoms and risk of all-cause and cardiovascular mortality among adults with and without diabetes: The REasons for Geographic And Racial Differences in Stroke (REGARDS) study
    Amandiy N.N. Liwo, Virginia J. Howard, Sha Zhu, Michelle Y. Martin, Monika M. Safford, Joshua S. Richman, Doyle M. Cummings, April P. Carson
    Journal of Diabetes and its Complications.2020; 34(10): 107672.     CrossRef
  • Impact of prediabetes on poststroke depression in Chinese patients with acute ischemic stroke
    Meijuan Xiao, Qiongzhang Wang, Wenwei Ren, Zheng Zhang, Xujie Wu, Zhen Wang, Liang Feng, Siyan Chen, Jincai He
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  • Response: Prevalence of Depression and Glucose Abnormality in an Urbanizing Rural Population of Bangladesh (Diabetes Metab J2015;39:218-29)
    Khurshid Natasha, Akhtar Hussain, A. K. Azad Khan, Bishwajit Bhowmik
    Diabetes & Metabolism Journal.2015; 39(6): 530.     CrossRef
  • Letter: Prevalence of Depression and Glucose Abnormality in an Urbanizing Rural Population of Bangladesh (Diabetes Metab J2015;39:218-29)
    Tomoyuki Kawada
    Diabetes & Metabolism Journal.2015; 39(6): 528.     CrossRef
Relationship between Opium Abuse and Severity of Depression in Type 2 Diabetic Patients
Sepehrmanesh Zahra, Sarmast Hossein, Kord Valeshabad Ali
Diabetes Metab J. 2012;36(2):157-162.   Published online April 17, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.2.157
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AbstractAbstract PDFPubReader   
Background

Opium use in diabetic populations is associated with major depressive disorder (MDD). This study was designed to investigate the relationship between opium use and severity of depression in Iranian diabetic patients.

Methods

In this case-control study, 642 type 2 diabetic patients were recruited from those presenting at two outpatient clinics at the Akhavan Hospital in Kashan, Iran; of them, 600 diabetic patients were included in the study and divided into two groups: opium-abusers (150 patients) and non-opium-abusers (450 patients). Clinical and demographic information was obtained through a detailed questionnaire. Depression symptomalogy and severity were assessed with the Beck Depression Inventory (BDI), and a corresponding diagnosis was made based on the Diagnostic and Statistical Manual of Mental Disorders-IV, Text Revision, 2000 (DSM-IV TR) criteria.

Results

The mean depression score was higher in the opium abuse group than in the non-abuser group (29.27±1.44 vs. 18.29±1.31, P<0.001). In general, a significant association was found between opium abuse and depression among patients (odds ratio [OR], 4.54; 95% confidence interval [CI], 2.87 to 7.44; P=0.001). No significant relationship was found between dysthymia and opium abuse (OR, 0.68; 95% CI, 0.18 to 1.192; P=0.155), while MDD was significantly higher in the opium abuser group (OR, 7.32; 95% CI, 5.20 to 12.01; P<0.001).

Conclusion

Depression is more frequent in opium-dependent diabetic patients, and its severity is also greater. Given these findings, opium-dependent diabetic patients should be advised about the increased risks of depression and related comorbidities.

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  • Prevalence of and factors associated with depression among hill tribe individuals aged 30 years and over in Thailand
    Chalitar Chomchoei, Tawatchai Apidechkul, Vivat Keawdounglek, Chanyanut Wongfu, Siriyaporn Khunthason, Niwed Kullawong, Ratipark Tamornpark, Panupong Upala, Fartima Yeemard
    Heliyon.2020; 6(6): e04273.     CrossRef
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    Mohammad Khaledi, Fahimeh Haghighatdoost, Awat Feizi, Ashraf Aminorroaya
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Depression and Self-care Behavior in Patients with Diabetes Mellitus.
Su Yoen Kim, Jae Ho Lee, Ha Neul Kim, Dong Kyu Kim, Young Na, Guil Sun Kim, Mee Kyoung Kim, Ki Hyun Baek, Moo IL Kang, Kwang Woo Lee, Ki Ho Song
Korean Diabetes J. 2009;33(5):432-438.   Published online October 1, 2009
DOI: https://doi.org/10.4093/kdj.2009.33.5.432
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AbstractAbstract PDF
BACKGROUND
Depression is known to be a risk factor for type 2 diabetes mellitus. Conversely, diabetes is also a risk factor for depression, and patients with diabetes have nearly twice the risk of comorbid depression as the general population. Depression in patients with diabetes may cause poor clinical outcomes through lower adherence to self-care activities such as exercise, diet control, and glucose monitoring. Furthermore, diabetic patients with depression are more likely to suffer from microvascular or macrovascular complications. We explored the prevalence of major depressive disorder in Korean diabetic patients and its impact on self-care activities and glucose control. METHODS: We surveyed depressive symptoms and self-care activities in 191 type 2 diabetic patients from the outpatient clinic of the St. Mary's hospital. Two questionnaires were used for assessment, the Harvard Department of Psychiatry/National Depression Screening Day Scale (HANDS) and the Summary of Diabetes Self-Care Activities (SDSCA). RESULTS: Of the 191 respondents who completed questionnaires, 39 (20.4%) patients were categorized as having major depressive disorder. Among the depressed patients, only six (15.3%) had been previously evaluated and managed for their psychiatric problems. The incidence of depression was significantly higher in female diabetic patients compared to patients without depression (74.4% vs. 45.4%, P<0.001). Patients with depression showed significantly poorer diet control (18.5 vs. 15.9, P = 0.046) and less glucose monitoring (4.1 vs. 2.7, P = 0.047). However, there were no differences in exercise, foot care, or smoking status between the two groups. Additionally, metabolic parameters such as HbA1C and lipid profile were not significantly different between the two groups. CONCLUSION: Many diabetic patients are suffering from depression and exhibit poorer self-care activities than patients without depression. Identifying and managing depressed diabetic patients may help improve their self-care activities.

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    Jin Hee Jung, Jung Hwa Lee
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    Youngrye Park, Eun Hee Jang, Ji Ok Kim
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    Han Na Sung, Hong Seok Chae, Eung Soo Kim, Jong Sung Kim
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Review
Diabetes, Depression and Doctor-Patient Relationship.
Hong seock Lee, Joong seo Lee, Heung pyo Lee, Chul eun Jeon
Korean Diabetes J. 2009;33(3):178-182.   Published online June 1, 2009
DOI: https://doi.org/10.4093/kdj.2009.33.3.178
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  • 3 Crossref
AbstractAbstract PDF
Although diabetes mellitus (DM) is treatable, it is still not curable. Its chronicity is associated with a high prevalence of psychiatric disorders, especially depression in type 2 DM and learned helplessness in type 1 DM. In turn, this depression and helplessness may affect a patient's adherence to medical appointments, compliance to treatment, and effective doctor-patient relationships, which are vital to promising outcomes. This study reviews the existing literature regarding the interactional relationships between depression, DM and the doctor/patient relationship, and also suggests certain aspects of the doctor/patient relationship which can contribute to more successful treatment outcomes.

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