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Open Access Research article

Association of depression with treatment outcomes in Type 2 Diabetes Mellitus: A cross-sectional study from Karachi, Pakistan

Saman I Zuberi1*, Ehsan U Syed1 and Junaid A Bhatti12

Author Affiliations

1 Aga Khan University Hospital, Karachi, Pakistan

2 Douglas Mental Health University Institute, Verdun, Canada

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BMC Psychiatry 2011, 11:27  doi:10.1186/1471-244X-11-27

Published: 15 February 2011



To assess the associations of depression with glycemic control and compliance to self-care activities in adult patients with Type 2 Diabetes Mellitus


This cross-sectional study was conducted at a tertiary-care hospital in Karachi (Aga Khan University Hospital). Equal numbers of depressed and non-depressed patients were consecutively recruited from the diabetic clinic. Information on demographic and clinical characteristics was collected in face-to-face interviews and from medical records. Hospital Anxiety Depression Scale (HADS) was used to measure depression. Associations of depressed status (HADS ≥ 8) with poor glycemic control (Hemoglobin A1c level ≥ 7%) and compliance to self-care activities were assessed by logistic regression analyses.


A total of 286 patients were included in this study with a male-female ratio of 1.2:1. Mean age was 52 years and in 64.7% of them, the duration of diabetes was more than 3 years. Depressed patients were more likely to be female (adjusted odds ratio [OR] = 1.88; 95% confidence interval [95%CI] = 1.07-3.31), had a family history of diabetes (OR = 2.64; 95%CI = 1.26-5.55), and poor glycemic control (OR = 5.57; 95%CI = 2.88-10.76) compared with non-depressed patients. Depression was also associated with low compliance to self-care activities such as taking dose as advised (OR = 0.32; 95%CI = 0.14-0.73), dietary restrictions (OR = 0.45; 95%CI = 0.26-0.79) and foot care (OR = 0.38; 95%CI = 0.18-0.83).


Adult patients with Type 2 Diabetes who have depression were more likely to have poor glycemic control and lower compliance to self-care activities, and they might need particular attention during follow-up visits.