Management of Depression for patients with type 2 diabetes mellitus in Australia

Background: The occurrence of type 2 diabetes mellitus (T2DM) co-morbidly with depression is extremely common, with diabetic patients having more than twice the risk of developing depression, and depression being a major risk factor for T2DM. In Australia, it is estimated that half of T2DM patients currently have depression, and this prevalence is much higher than the 6.2% seen in the general population (aged  6-85). Objective: To explore the relationship between T2DM and depression, investigate management options that may reduce the risk of depression, and ways to increase awareness about these non-communicable diseases. Methods: Data was examined from the 20   Diabetes-MILES study, a postal survey sent to  5,000 randomly selected adults from the National Diabetes Services Scheme database, with 3,338 respondents. It included questions regarding demographics, existing diabetic care, and the PHQ-9 questionnaire. From the dataset, we analysed the subset of respondents with T2DM (n= 962). Depression was defined as having a PHQ-9 score greater than 8. We examined factors impacting on the prevalence of depression in this population using both odds ratio methods and log odds models. Results: Respondents who reported lower rates of receiving necessary information or teaching about managing their issues from their diabetes care team were significantly more likely to suffer from depression (OR= .89 and  .58, respectively). Similarly, lower rates of inter-appointment contact from the diabetic care team for general follow-up were associated with higher rates of depression (OR= .76). Log odds models demonstrated strongly negative linear relationships between the frequency of depression and the rates of access to information and teaching. Conclusion: Improvements in provision of information, education and inter-appointment contact result in lower rates of depression in patients with T2DM.  This highlights the importance of access to diabetes education, information and inter-appointment contact to decrease rates of depression in T2DM patients