Study On The Risk Factors Of Type 2 Diabetic Comorbid Depression And The Effect Of Insulin Therapy On The Degree Of Depression

Objective: To explore the risk factors of type 2 diabetic comorbid depression and analyze the effect of insulin therapy on the degree of depression in patients with type 2 diabetic com orbid depression,so as to provide reference for clinical diagnosis and treatment of type 2 diabetic comorbid depression.Methods: 299 patients with type 2 diabetes who were hospitalized in the Department of Endocrinology,affiliated Hospital of Xiamen Medical College from June 2018 to June 2019 were randomly selected as the subjects of this experiment.The data collected included age,sex,body mass index,physical activity,education level,marital status,duration of diabetes,number of diabetic complica tions,diabetic distress(judged by Diabetes Distress Scale),glycosylated hemoglobin,triglyceride,serum cholesterol,high density lipoprotein cholesterol,low density lipoprotein cholesterol and so on.Among them,there were 153 males and 146 females.Th e average age of the patients was 46.17 ±5.45 years old,the minimum age was 30 years old,the maximum age was 57 years old,the average duration of disease was 5.97 ±2.45 years,and the glycosylated hemoglobin was 9.50 ±2.30%.Each patient with type 2 diabetes was scored with Hamilton Depression Scale.According to the results,the patients were divided into depression group and non-depression group.There were 133 cases of depression(including 87 cases of mild depression,44 cases of moderate depression and 2 cases of severe depression).There were 166 patients without depression.The depression group was further divided into insulin treatment group and non-insulin treatment group according to whether they were treated with insulin There were 85 patients in insulin treatment group,including 43 patients with mild depression,40 patients with moderate depression and 2 patients with severe depression,and 48 patients in non-insulin treatment group,including 44 patients with mild depression,4 patients with moderate depression and 0 patients with severe depression.SPSS19.0 statistical analysis software was used to compare the research data of patients in each group,and to find out the independent risk factors of type 2 diabetic comorbid depression and to analyze the effect of insulin treatment on the degree of depression.Results:1.The difference of Age,duration of diabetes,number of diabetic complications,sex,physical activity,diabetic distress,insulin therapy,glycosylated hemoglobin,triglyceride and cholesterol between depression group and non-depression group was statistically significant(P<0.05).The age and physical activity level of depression group were lower than those of non-depression group,and other items were higher than those of non-depression group.2.The duration of diabetes(R=0.142,P<0.05),the number of diabetic complications(R=0.247,P<0.05),diabetes distress(R=0.242,P<0.05),insulin therapy(R=0.300,P<0.05),gender(female)(R=0.351,P<0.05),Hb Alc(R=0.262,P<0.05),TC(R=0.187,P<0.05),TG(R=0.179,P<0.05)were positively correlated with T2 DM comorbid depression,while physical activity(R=-0.146,P<0.05)and age(R=-0.205,P<0.05)were negatively correlated with T2 DM comorbid depression.3.Logistic regression analysis showed age(OR=0.891,95%CI 0.837),sex(OR=1.953,95%CI 1.085),number of diabetic complications(OR=1.651,95%CI 1.248),diabetic distress(OR=2.045,95%CI 1.151)and duration of diabetes(OR=1.184,95%CI 1.049 Mel 1.336),glycosylated hemoglobin(OR=1.282,95%CI 1.123 Mel 1.463),insulin therapy(OR=3.326,95%CI 1.862 Mel 5.942).4.There was significant difference in the degree of depression between the insulin treatment group and the non-insulin treatment group(P < 0.05).The proportion of patients with moderate or more depression in the non-insulin treatment group was lower than that in the insulin treatment group.5.Gender(female),diabetes distress,insulin treatment were positively correlated with the degree of depression.After adjusting the confounding factors,Logi stic regression analysis showed that insulin therapy(OR=11.305,95%CI 3.490 Mel 36.622).Conclusions:1.The duration of diabetes,the number of diabetic complications,diabetes distress,insulin therapy,gender(female),Hb Alc,TC,TG were positively correlated with T2 DM comorbid depression,while physical activity and age were negatively correlated with T2 DM comorbid depression.2.Age,female,number of diabetic complications,duration of diabetes,diabetic pain,glycosylated hemoglobin and insulin therapy are independent risk factors for T2 DM comorbid depressio n.3.Insulin therapy can aggravate depression in patients with T2 DM,and insulin therapy is an independent risk factor affecting the degree of depression.