Highlights
- •Depression and anxiety are common among Egyptian patients with type 1 diabetes.
- •Female sex is related to depression but not to anxiety.
- •HbA1c and HFS-II are independently correlated with both anxiety and depression.
- •Anxiety and depression are correlated with HFS-B, HFS-W and HFS-II total score.
Abstract
Background and aims
Emotional problems including anxiety, depression and fear of hypoglycemia (FOH) are
common in patients with type 1 diabetes mellitus (T1DM). The aim of this study was
to determine the prevalence of depressive and anxiety symptoms among patients with
T1DM and their relation to glycemic control, diabetes complications and to FOH.
Methods
This study included 325 patients with T1DM. Anxiety and depressive symptoms were assessed
by Hospital Anxiety and Depression Scale (HADS) and FOH was assessed by Hypoglycemia
Fear Survey II (HFS-II). Glycemic control was assessed by both fasting plasma glucose
and HbA1c. A subsample of 75 patients was screened for diabetes complications.
Results
The prevalence of anxiety symptoms, depressive symptoms and FOH was 76.3%, 61.8% and
20% respectively. Female sex was related to depressive symptoms but not to anxiety
symptoms. Logistic regression analysis showed that both HbA1c and HFS-II total score
were independently correlated with both anxiety symptoms and depressive symptoms.
Age showed independent correlation with both HFS-II (total score) and with Hypoglycemia
Fear Survey-worry (HFS-W) while HbA1c showed independent correlation with Hypoglycemia
Fear Survey-behavior (HFS-B). Both anxiety and depressive symptoms were positively correlated to HFS-B score,
HFS-W score and HFS-II total score.
Conclusions
FOH is not uncommon among Egyptian patients with T1DM and it seems to be one of the
factors contributing to the increased prevalence of anxiety and depressive symptoms
among those individuals. Addressing and managing the different psychological aspects
of diabetes should be integrated within the routine diabetes care services for people
with T1DM.
Abbreviations:
ABI (Ankle brachial index), FOH (fear of hypoglycemia), HADS (Hospital Anxiety and Depression Scale), HFS-II (Hypoglycemia Fear Survey II), T1DM (type 1 diabetes mellitus), UACR (urinary albumin to creatinine ratio), VPT (vibration perception threshold)Keywords
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Article info
Publication history
Published online: March 14, 2023
Accepted:
March 5,
2023
Received in revised form:
February 22,
2023
Received:
November 16,
2022
Identification
Copyright
© 2023 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.
