ROLE OF ANTIDEPRESSANT ON THE GLYCAEMIC CONTROL OF UNCONTROLLED TYPE 2 DIABETES MELLITUS PATIENTS

ALLU HARSHAVARDHINI; BHANUKUMAR MUTHAIAH; TIRIN BABU; GEORGE MATHEW PANACHIYIL; SISIRA SANTHOSH; SARAYU SANTHOSH

doi:10.22159/ajpcr.2020.v13i7.37809

Authors

ALLU HARSHAVARDHINI Department of General Medicine, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India.
BHANUKUMAR MUTHAIAH Department of General Medicine, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India.
TIRIN BABU Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India.
GEORGE MATHEW PANACHIYIL Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India.
SISIRA SANTHOSH Department of Anaesthesiology, IMS and SUM Hospital, Bhubaneswar, Odisha, India.
SARAYU SANTHOSH Department of General Medicine, Adichunchanagiri Institute of Medical Sciences, Mandya, B.G Nagara, Karnataka, India.

DOI:

https://doi.org/10.22159/ajpcr.2020.v13i7.37809

Keywords:

Type 2 diabetes mellitus, Depression, Antidepressant, Glycemic control

Abstract

Background: Depression incidence is higher in diabetic patients when compared to the non-diabetic individuals and there exist a two-directional relationship between depression and the development of type 2 diabetes mellitus.

Objectives: This study aimed to estimate the frequency of depression and the effect of antidepressant on glycemic control in type 2 diabetes mellitus patients.

Methods: This prospective interventional study was conducted in type 2 diabetes mellitus patients with a sample size of 100. These patients were diagnosed with depression using WHO-ICD10 criteria. All study patients had uncontrolled blood glucose levels and were on an optimized maximal dose of combination oral hypoglycemic agents with stable glycoregulation (HbA1c 8.4 ±0.5) were taken up for the intervention with antidepressant. These patients were started on with antidepressant after enrollment and followed up for fasting blood sugar (FBS), post-prandial blood sugar (PPBS), and HbA1c at the end of 3 months and 6 months. And also Hamilton depression rating scale scores were estimated at the beginning of the study and at the end of 6 months.

Results: The frequency of depression among the type 2 diabetes mellitus patients was found to be 42%. There were reduction of mean FBS levels from baseline value of 177 mg/dl to follow-up value of 160 mg/dl (p<0.001), mean PPBS levels from 251.16 mg/dl to 217.84 mg/dl (p<0.001), and mean HbA1c dropped from 8.41 to 7.57 (p<0.001) after the treatment with antidepressant.

Conclusion: Our study concluded that patient started on antidepressant showed a reduction in the blood sugar levels and HbA1c levels from their baseline values, which was clinically and statistically significant.

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Author Biographies

ALLU HARSHAVARDHINI, Department of General Medicine, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India.

M.D. General Medicine, Department of General Medicine, JSS Medical College and Hospital, JSS Academy of Higher Education & Research, Mysuru, Karnataka – 570015, India.

BHANUKUMAR MUTHAIAH, Department of General Medicine, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India.

Professor, Department of General Medicine, JSS Medical College and Hospital, JSS Academy of Higher Education & Research, Mysuru, Karnataka – 570015, India.

TIRIN BABU, Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India.

Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysuru, Karnataka – 570015, India

GEORGE MATHEW PANACHIYIL, Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India.

Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysuru, Karnataka – 570015, India

SISIRA SANTHOSH, Department of Anaesthesiology, IMS and SUM Hospital, Bhubaneswar, Odisha, India.

MBBS, Adichunchanagiri Institute of Medical Sciences, Mandya Dist, B.G Nagara, Karnataka 571448.

SARAYU SANTHOSH, Department of General Medicine, Adichunchanagiri Institute of Medical Sciences, Mandya, B.G Nagara, Karnataka, India.

MBBS, Adichunchanagiri Institute of Medical Sciences, Mandya Dist, B.G Nagara, Karnataka 571448.

References

Da Silva JA, De Souza EC, Böschemeier AG, Da Costa CC, Bezerra HS, Feitosa EE. Diagnosis of diabetes mellitus and living with a chronic condition: participatory study. BMC Public Health 2018;18:699.

Hu FB. Globalization of diabetes: The role of diet, lifestyle, and genes. Diabetes Care 2011;34:1249-57.

Anjana RM, Pradeepa R, Deepa M, Datta M, Sudha V, Unnikrishnan R, et al. The Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) study: Methodological details. J Diabetes Sci Technol 2011;5:906-14.

Alzoubi A, Abunaser R, Khassawneh A, Alfaqih M, Khasawneh A, Abdo N. The bidirectional relationship between diabetes and depression: A literature review. Korean J Fam Med 2018;39:137-46.

Egede LE, Ellis C. Diabetes and depression: Global perspectives. Diabetes Res Clin Pract 2010;87:302-12.

Avasthi A, Grover S, Bharadwaj R. Clinical practice guidelines for management of depression in elderly. Indian J Psychiatry 2018;60:S341-62.

Vishnupriya R, Ezhilramya J, Meenakshi B. Metformin in the prevention of metabolic syndrome associated with initiation of atypical antipsychotic therapy in adolescents and young adults-a randomized, open labelled, single centered study. Int J Pharm Pharm Sci 2016;8:200-6.

Ogbonna BO, Ezenduka CC. Drug use indicators in patients with Type 2 diabetes in a teriary healthcare facility in Nigeria. Int J Pharm Pharm Sci 2014;6:493-5.

Dhavale HS, Panikkar V, Jadhav BS, Ghulghule M, Agari AD. Depression and diabetes: Impact of antidepressant medications on glycaemic control. J Assoc Physicians India 2013;61:896-9.

Gehlawat P, Gupta R, Rajput R, Gahlan D, Gehlawat VK. Diabetes with comorbid depression: Role of SSRI in better glycemic control. Asian J Psychiatr 2013;6:364-8.

Das R, Singh O, Thakurta RG, Khandakar MR, Ali SN, Mallick AK, et al. Prevalence of depression in patients with Type II diabetes mellitus and its impact on quality of life. Indian J Psychol Med 2013;35:284-9.

Mushtaque A, Gulati R, Hossain MM, Azmi SA. Prevalence of depression in patients of Type 2 diabetes mellitus: A cross sectional study in a tertiary care centre. Diabetes Metab Syndr 2016;10:238-41.

Ali S, Stone MA, Peters JL, Davies MJ, Khunti K. The prevalence of co-morbid depression in adults with Type 2 diabetes: A systematic review and meta-analysis. Diabet Med 2006;23:1165-73.

Nicolau J, Rivera R, Francés C, Chacártegui B, Masmiquel L. Treatment of depression in Type 2 diabetic patients: Effects on depressive symptoms, quality of life and metabolic control. Diabetes Res Clin Pract 2013;101:148-52.

Wiltink J, Michal M, Wild PS, Schneider A, König J, Blettner M, et al. Associations between depression and diabetes in the community: Do symptom dimensions matter? Results from the Gutenberg health study. PLoS One 2014;9:e105499.