Introduction: Depression, anxiety and eating disorders appear more frequently in patients with type 2 diabetes and are associated with worse metabolic control and higher risk of developing micro and macrovascular complications. The aim of this study was to determine the prevalence of psychiatric comorbidities in diabetic patients, candidates for therapy with SGLT2 inhibitors (SGLT2i) and to evaluate their clinical profile and degree of metabolic control before beginning the treatment.
Methods: 225 diabetic patients included in a therapy protocol with SGLT2i were evaluated analyzing clinical characteristics, biochemical parameters, lifestyle and pharmacological therapy. The analysis was performed separating patients in two groups according to the presence of psychiatric comorbidity. Quantitative variables are expressed by mean (standard deviations). Qualitative variables are expressed by frequencies and percentages. We consider significant P<0.05.
Results: 55 patients (24.4%) of the total, 25 (54.5%) women, mean age 63 (S.D. 10.5), had psychiatric comorbidities and the most frequent diagnoses were anxiety (34.5%), depression (32.7%) and anxiety-depressive syndrome (16.4%); time of evolution of diabetes 11.1 years (S.D. 9.4), BMI 35 kg/m2 (S.D. 6.2), systolic blood pressure 146.3 mmHg (S.D. 18.9), plasma glucose 173.3 mg/dl (S.D. 50.5), glycated hemoglobin (HbA1c) 8.2% (S.D. 1.02) cholesterol 186 mg/dl (S.D. 45.3), low-density lipoprotein cholesterol (LDL-C) 106 mg/dl (S.D. 40), high-density lipoprotein cholesterol (HDL-C) 48.9 mg/dl (S.D. 15.5), triglycerides 189.2 mg/dl (S.D. 89.2); 9.8% smoked; 41.8% met dietary recommendations; 34.5% performed physical exercise; 9% did not receive antihyperglycemic drugs; 16.4% received one, 47.3% two and 27.3% triple therapy; 41.8% of patients were treated with Insulin; 76.4% took lipid-lowering drugs; 36.4% had presented a cardiovascular event (ischemic cardiopathy, stroke, peripheral vasculopathy). The HDL-C was significantly higher in patients with psychiatric comorbidity (P=0.007), but there were no significant differences neither in the prescription of lipid-lowering drugs nor in the rest of parameters evaluated compared with diabetics without psychiatric pathology.
Conclusions: The prevalence of psychiatric comorbidities in diabetic patients included in this study agrees with that described in literature. However, we found no association with a higher BMI, lower adherence to changes in lifestyle, worse metabolic control, a greater prescription of antihyperglycemic drugs and Insulin or a higher prevalence of cardiovascular events compared with diabetics without psychiatric pathology. According to some authors, this could be due to depression and anxiety oriented treatment.
18 - 21 May 2019
European Society of Endocrinology