Background Diabetes mellitus (DM) causes serious deterioration in general quality of life (QoL) mainly affecting the health-related quality of life (HRQOL). Routine assessment of QoL improves communication with the patient, helps to predict treatment response, and supports clinical decision-making. QoL can predict an individual's capacity to manage the disease and maintain long-term health and wellbeing. Aims To find out the QoL and its socio-demographic, anthropometric, and clinical determinants among DM patients attending health institutions from sub-Himalayan region, catering rural population. Settings and design This cross-sectional study was conducted in two hospitals mostly catering rural population from 2014 to 2018. Purposive sampling technique was used. Materials and methods Socio-demographic, anthropometric, and clinical data of DM patients (N = 300) were collected. They were administeredHindi translation of QoL Instrument for Indian Diabetes Patients (QOLID) and Patient Health Questionnaire-9 (PHQ-9). All statistical analyses were carried out using Statistical Package for Social Sciences (SSPS) (Version 17.0, USA). Results About 10% had very poor, 13% poor, 11% average, 16% good, and 50% very good QoL on QOLID. General health (GH) and treatment satisfaction (TS) were the most affected domains. Fatigue was the most common symptom (79%) reported in QOLID. Age more than 55 years, rural background, and PHQ-9 score of more than 7 were predictors of poorer QoL. Conclusion There is a need for a holistic and collaborative care of DM patients, to maintain a good HRQoL. Screening of depression, fatigue, and regular assessment of QoL should be emphasized.

Quality of Life and its Determinants in Patients with Diabetes Mellitus from Two Health Institutions of Sub-himalayan Region of India.

The rising prevalence of depression among Type 2 Diabetes Mellitus (T2DM) patients has triggered an alarming situation, and further actions need to be taken by health care professionals and policymakers to curb the issue. There is a lack of evidence review in terms of the biopsychosocial and nutritional factors that are related to depression among T2DM. Hence, this review aimed to identify available evidence on the biopsychosocial and nutritional factors associated with depression among T2DM patients based on the existing literature. Articles were systematically searched from four databases, namely PubMed, Scopus, Web of Science, and EBSCOHost. The approach for the identification of the final articles followed PRISMA guidelines. The selected full-text articles were published between 2017 and 2021 in the English language, and included studies focused on depression among T2DM patients. Using AXIS tools, the eligible articles were evaluated to assess the quality of studies. A total of 19 studies were included in the review, and information related to research questions and associated factors was extracted. Biological, psychological, social, and nutritional factors were shown to be linked with depression among T2DM patients. Future studies need to considered using the biopsychosocial model and incorporating nutritional factors to manage the issues of depression among T2DM patients.

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Biopsychosocial and Nutritional Factors of Depression among Type 2 Diabetes Mellitus Patients: A Systematic Review


 Background: Perceived Social Support which referred to an individual's extent of satisfaction regarding his/her necessary support, information, and interactions. According to (Procidano, 1983), PSS is a key element for understanding supportive behavior and is assumed to determine its association with depression. This 12-item scale is considered a substantial component that influences the emotional well-being of chronic patients. Hence, this paper is intended to validate the English version of Perceived Social Support among WLHIV. Methods: A facility-based cross-sectional study was conducted in WLHIV who attends the ART treatment of selected hospitals. A total of 357 attendees were recruited for a broader mixed-method designed study. The English version of PSS was translated into a national Somali language. The internal consistency was measured to analyze the reliability and Principle Component Analysis (PCA) was used to determine the validity of the study.Results: The findings of this study reveals that the PSS has shown a good internal consistency with Cronbach alpha greater than 0.60. Based on the principle component analysis, the validity construct of the scale was also measured showing a Varimax rotation of the components was successfully loaded and eigenvalue was greater than 1. Conclusion: This version, Perceived Social Support (PSS) is fit to be introduced in the health institutions for screening the level of support of chronic patients particularly its suitability for applications in the ART treatment services.

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A validation study of Perceived Social Support (PSS) of chronic patients in Antiretroviral clinics

Diabetic nephropathy is a common complication among patients with diabetes mellitus, and it has been linked to a higher risk of depression. However, the magnitude of this association remains unclear. This study aimed to systematically review and meta-analyse the risk of depression in patients with diabetic nephropathy compared to diabetes patients without nephropathy. We conducted a systematic literature review, searching multiple databases from January 1964 to March 2023, and included randomized controlled trials, non-randomized controlled trials, and observational studies. We assessed the risk of bias using the Newcastle Ottawa scale for observational studies. The statistical analysis was performed using STATA version 14.2, and pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated. A total of 60 studies were included. The pooled OR for the risk of depression among patients with diabetic nephropathy was 1.78 (95% CI 1.56–2.04; I2 = 83%; n = 56), indicating a significantly higher risk compared to diabetes patients without nephropathy (p < 0.001). Pooling the effect size across these studies showed that the pooled OR was 1.15 (95% CI 1.14–1.16; I2 = 88%; n = 32). Subgroup analyses based on the type of diabetes and study region revealed no significant differences in the pooled estimates. This study demonstrates that patients with diabetic nephropathy have a significantly higher risk of depression compared to diabetes patients without nephropathy. These findings highlight the importance of assessing and addressing the mental health of patients with diabetic nephropathy as part of their overall healthcare management. 

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The Hidden Burden—Exploring Depression Risk in Patients with Diabetic Nephropathy: A Systematic Review and Meta-Analysis

Background: Diabetes mellitus (DM) poses a greater risk of depression and a poor quality of life (QoL). There is a limited data regarding relationship of depression to QoL in patients from rural health care settings of North India. Aim: To know the prevalence and predictors of depression in patients of DM among various sociodemographic, clinical and QoL variables. Settings and Design: This cross-sectional study was conducted in two hospitals of North India mostly catering rural population from 2014 to 2018. Materials and Methods: Sociodemographic and clinical data of DM patients was collected. They were applied Hindi translation of QoL Instrument for Indian Diabetes Patients and Patient Health Questionnaire-9. Analyses were done by Statistical Package for Social Sciences (Version 17.0, USA). Results: Among 300 patients, 25.6% had clinical depression. Illiteracy, the affect on general, emotional/mental health and role limitation by diabetes predicted risk of depression. Conclusion: Education of patients regarding self-management in DM to assure good health should be emphasised.

Depression prevalence, its psychosocial and clinical predictors, in diabetes mellitus patients attending two health institutions of north India catering rural population.

Pankaj Kanwar

Papers

Depression prevalence, its psychosocial and clinical predictors, in diabetes mellitus patients attending two health institutions of north India catering rural population.

Burnout during covid-19 pandemic among health care workers of a tertiary care centre in northern india: a cross sectional study.