Category: Diabetes/Prediabetes/Hypoglycemia

Monitor: 16

16 - TYPE 2 DIABETES AND DEPRESSION IN INDIA: LESSONS FROM THE INTERNATIONAL PREVALENCE AND TREATMENT OF DIABETES AND DEPRESSION (INTERPRET-DD) STUDY, A COLLABORATIVE STUDY CARRIED OUT IN 14 COUNTRIES.

Thursday, Apr 25
1:30 PM – 2:00 PM

Objective :

To evaluate prevalence and correlates of depressive disorders in people with T2DM attending Samatvam – Jnana Sanjeevini Diabetes Center, India.


Methods :

INTERPRET DD international study, the largest of this type ever undertaken [2783 people with T2DM, from 14 countries: Argentina, Bangladesh, China, Germany, India, Italy, Kenya, Mexico, Pakistan, Poland, Russia, Serbia, Uganda, Ukraine], has emphasised the urgent need for prompt identification and appropriate care for psychological and psychiatric problems in people with T2DM, both to improve glycemic control and to reduce chronic complications]. Diabet Med. 2018 Jun; 35(6):760-769.


Indian component of INTERPRET DD:


Diabetes Partner: Samatvam Jnana Sanjeevini Diabetes Center


Psychiatry Partner: National Institute of Mental Health and Neuro Sciences, NIMHANS


Number enrolled= 197 consecutive T2DM subjects


Follow up= 2 years [One year data presented].


Results :

India vs Global TOTAL data :


Country   Men (%)  Age Yr   Duration Yr  Urban (%)  Higher Edu (%)Low SES (%)Smoking (%)


India          53             53          8.3                84               17                      23                 5


TOTAL       45             54          8.8                85               31                      17                 14


Psychological evaluations: Patient Health Questionnaire (PHQ-9) and the Problem Areas in Diabetes Scale (PAID); Psychiatric interview conducted by trained interviewer using MINI International Neuropsychiatric Interview (MINI).


Country                   Current MDD %    Previous MDD %     Recurrent MDD %        Lifetime MDD %


India                             2.0                          0.5                            0.5                                 2.0


GLOBAL TOTAL        10.6                         10.5                          4.6                                 16.6


Major Depressive Disorder (MDD)


Country                             PHQ-9 >9 %                         PAID score >40%


India                                     15.7                                      1.0


GLOBAL TOTAL                 17.0                                      12.8


Moderate-severe depressive symptomatology (PHQ-9 >9)


PAID (diabetes distress) score >40


Discussion :

The prevalence of Current MDD, Previous MDD, Recurrent MDD and Lifetime MDD, was significantly much less in the Samatvam – Jnana Sanjeevini Cohort from India, compared to the Global Total.  However, the prevalence of Moderate-severe depressive symptomatology (PHQ-9 >9) %, was similar in our cohort, compared to Global Total.  But the PAID (diabetes distress) score >40 was much less in or cohort.


Conclusion :

Prevalence of depression in type 2 diabetes within India [Intra-country comparisons]:


Samatvam – Jnana Sanjeevini Cohort= 2% [INTERPRET DD]


Reported from other Diabetes Centres in India= 27-39% [perhaps less rigorous assessments compared with INTERPRET DD]


Still, even within India, why is depression relatively much less in Samatvam – Jnana Sanjeevini Cohort? Possibilities: The institutions 3 decade long “holistic” philosophy in diabetes care [provision of equal attention to body, mind and Spirit, not just pharmacotherapy; Institution’s Mission: Integration of Science and Spirituality in the context of health care].

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Muralidhara Krishna

Consultant Faculty Endocrinology Diabetes Biochemistry
Samatvam Jnana Sanjeevini Diabetes Hospital and Medical Center
Bangalore, Karnataka, India

Designation: Consultant and Faculty: Endocrinology Diabetes Metabolism; Associate Professor: Clinical Biochemistry and Laboratory Medicine
Specialties: Endocrinology Diabetes Metabolism; Clinical Biochemistry
Clinical Interests: Diabetes mellitus; Thyroid Disorders; Obesity; Dyslipidemia.

Vasanthi Nath

Consultant Faculty Endocrinology Diabetes
Samatvam Jnana Sanjeevini Diabetes Hospital and Medical Center
Bangalore, Karnataka, India

Designation: Consultant and Faculty
Specialties: Endocrinology, Diabetes, Internal Medicine, Geriatrics
Clinical Interests: Neuroendocrinology and Neurometabolism, Metabolic Myopathies; Thyroid tumors, Geriatric Endocrinology, Inpatient Diabetes Care and Endocrine Emergencies; Type 1 diabetes across ages

Kavitha Muniraj

Consultant Faculty Endocrinology Diabetes
Samatvam Jnana Sanjeevini Diabetes Hospital and Medical Center
Bangalore, Karnataka, India

Designation: Consultant and Faculty; Director Medical ; Director Research; Trustee
Specialties: Endocrinology Diabetes; Clinical Research
Clinical Interests: Pituitary Adrenal disorders; Bone health; Cardiovascular Health; Thyroid dysfunction; Diabetes Pharmacotherapy; Clinical Pharmacology; Pharmacovigilance; Clinical research Safety and Audits

Chandraprabha S

Consultant Faculty Endocrinology Diabetes
Samatvam Jnana Sanjeevini Diabetes Hospital and Medical Center
Bangalore, Karnataka, India

Designation: Consultant and Faculty
Specialties: Endocrinology Diabetes Metabolism
Clinical Interests: Pregnancy Diabetes, Pregnancy Thyroid Dysfunction, Women Health, Geriatric Endocrinology, Diabetes mellitus and Mental Health, Spiritual Medicine

Babitha D. T

Consultant Faculty Endocrinology Diabetes
Samatvam Jnana Sanjeevini Diabetes Hospital and Medical Center
Bangalore, Karnataka, India

Designation: Consultant and Faculty
Specialties: Endocrinology, Diabetes
Clinical Interests: Endocrine disorders of pregnancy, Pregnancy Diabetes, Cardiovascular Health, Thyroid, Inpatient diabetes care and endocrine metabolic emergencies

Reshma B. Vijay

Consultant Faculty Endocrinology Diabetes
Samatvam Jnana Sanjeevini Diabetes Hospital and Medical Center
Bangalore, Karnataka, India

Designation: Consultant and Faculty
Specialties: Endocrinology Diabetes and Metabolism
Clinical Interests: Pediatric Endocrinology; Diabetes mellitus; Insulin Pumps, Continuous Glucose Monitoring and Artificial Pancreas; Growth and Puberty; Thyroid; Pituitary Adrenal disorders

Jayalakshmi T

Consultant Faculty Endocrinology Diabetes
Samatvam Jnana Sanjeevini Diabetes Hospital and Medical Center
Bangalore, Karnataka, India

Designation: Consultant and Faculty

Specialties: Endocrinology, Diabetes, Internal Medicine,
Clinical Interests: Diabetes mellitus, Cardiovascular Health, Thyroid, In Patient Diabetes Care, Endocrinology Metabolic emergencies and critical care

Nidhi Garg

Consultant Faculty Endocrinology Diabetes
Samatvam Jnana Sanjeevini Diabetes Hospital and Medical Center
bangalore, Karnataka, India

Designation: Senior Consultant and Faculty
Specialties: Diabetes and Metabolism
Clinical Interests: Comprehensive diabetes care, In-patient diabetes and metabolic care, Perioperative diabetes management, Diabetes and endocrine emergencies – Metabolic Intensive Care, Obesity management, Lipids and preventive cardiology, Gestational diabetes, Thyroid disorders, Type 1 diabetes across ages

Madhumati S Vaishnav

Scientist Faculty
Samatvam Jnana Sanjeevini Diabetes Hospital and Medical Center; CENSE Indian Institute of Science, India

B.Sc (Microbiology), University of Pune, India.
M.Sc (Microbiology), University of Pune, India.
Post Graduate Diploma in Clinical Research and Clinical Data Management, University of Pune, India
CDE (Certified Diabetes Educator - Counselor), Samatvam Institute of Medical Sciences, India

Apoorva Govind

Consultant Faculty Endocrinology Diabetes
Samatvam Jnana Sanjeevini Diabetes Hospital and Medical Center
Bangalore, India

Designation: (a) Fellow: Endocrinology Diabetes Medicine, Samatvam Endocrinology Diabetes Centre and Jnana Sanjeevini Medical Centre and Diabetes Hospital ; (b) Co Investigator – Clinical Research, Samatvam Science and Research Center

Specialties: Endocrinology, Diabetes, Internal Medicine

MD Chitra

Consultant Faculty Endocrinology Diabetes
Samatvam Jnana Sanjeevini Diabetes Hospital and Medical Center

Designation: Consultant and Faculty; Trustee
Specialties: Endocrinology Diabetes; Clinical Research
Clinical Interests: Diabetes, Obesity, Dyslipidemia, Osteoporosis, Pituitary Adrenal disorders; Bone health; Cardiovascular Health; Thyroid dysfunction;

Vasudha Srikanth


India

Sathvik Reddy Chinna Bainagari

Resident Doctor
Samatvam jnana sanjeevini Diabetes hospital and medical center
Chittoor, Andhra Pradesh, India

Nalini Rayas

Siddartha Dinesha

Resident, Medicine Diabetes Endocrinology
Samatvam Jnana Sanjeevini Diabetes Hospital and Medical Center

Designation: Resident: Medicine; Endocrinology Diabetes, Samatvam Endocrinology Diabetes Centre and Jnana Sanjeevini Medical Centre and Diabetes Hospital
Specialties: Endocrinology, Diabetes, Internal Medicine

Namya Gaekwad

Sri Srikanta

Santhosh Chaturvedi