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ISSN 1405-8871 (Print)

2018, Number 3

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Aten Fam 2018; 25 (3)

Comprehensive Treatment in Depressed or Anxious Patients Suffering Diabetes Mellitus Type 2

López NK, Acevedo GO, Hernández HMÁ

Language: Spanish
References: 23
Page: 97-102
PDF size: 739.55 Kb.


ABSTRACT

Objective: describe the response of patients, diagnosed with diabetes mellitus type 2 (DM2), depression or anxiety, to a comprehensive treatment. Methods: quasi-experimental study, sample of 39 patients, beneficiaries of a Family Medicine Clinic in Mexico City, assessed from February to June 2017. Patients with uncontrolled DM2, and depression or anxiety diagnosis were included. The scales of Zung and Beck were used to assess depression and anxiety, respectively. A comprehensive management was given, including pharmacological adjustment, psychoeducational and nutritional interventions. A post-treatment evaluation was carried out and new clinical and biochemical parameters were collected. The Wilcoxon range test was used to relate the glycosylated hemoglobin values and to compare the results of the depression and anxiety depression before and after the treatment. Results: an average age of 52 ± 8.12 years, with 59% (n=23) female. The media in the pre-intervention was: 10.29 ± 2.29% for HbA1c, 53.1 ± 8.47 points for depression and 14.82 ± 8.08 points for anxiety. The post-intervention results were: 7.53 ± 1.56% for HbA1c, 45.12 ± 8.83 points for depression and 9.38 ± 7.28 points for anxiety, with statistically significant differences p‹0.05 for HbA1c, depression, and anxiety. Conclusions: comprehensive treatment in patients with Diabetes Mellitus Type 2 reduces the HbA1C levels and the symptomatology level of depression or anxiety; other studies are required to evaluate the treatment effectiveness.


REFERENCES

  1. Organización Mundial de la Salud. Informe mundial sobre la diabetes: Resumen de orientación [internet. Consultado el 16 de noviembre de 2017]. Disponible en: http://apps.who.int/ iris/bitstream/10665/204877/1/WHO_NMH_ NVI_16.3_spa.pdf?ua=1

  2. Power C. Diabetes mellitus: diagnóstico, fisiopatología, tratamiento y complicaciones. En: Longo DL, Jameson L, Fauci AS, et al, editores. Harrison. Principios de Medicina Interna. Vol. 2. México: Mc Graw Hill;2015,2399-2429.

  3. Secretaría de Salud. Encuesta Nacional de Salud y Nutrición de medio camino 2016. Instituto Nacional de Salud Pública [internet. Consultado el 13 de noviembre 2017]. Disponible en: http:// promocion.salud.gob.mx/dgps/descargas1/ doctos_2016/ensanut_mc_2016-310oct.pdf

  4. González I, González S. Diabetes y Depresión. Cuestión de riesgo. Diabetes Práctica. 2015;06(01):1-48.

  5. Wang L, Song R, Chen Z, Wang J, Ling F. Prevalence of depressive symptoms and factors associated with it in type 2 diabetic patiens: a cross-sectional study in China. BMC Public Health. 2015;15:188.

  6. Khuwaja KA, Lalani S, Dhanani R, Azam SI, Rafique G, White F. Anxiety and depression among outpatients with type 2 Diabetes: A multi-centre study of prevalence and associated factors. Diabetol Metab Syndr; 2010;2:72.

  7. Martínez HF, Tovilla ZC, López NL, Juárez R I, Jiménez SM, González GC et al. Prevalencia y gravedad de la Depresión y la Ansiedad en pacientes con obesidad y Diabetes de tipo 2: estudio en población de Tabasco, México. Gac Med Mex. 2014; 150(1):101-106.

  8. Ciechanowski PS, Katon WJ, Russo JE. Depression and Diabetes. Impact of depressive symptoms on Adherence, function and costs. Arch Med Int. 2000;160:3278-285

  9. Castillo QJ, Barrera BD, Pérez OJ, Álvarez CF. Depresión y Diabetes: de la epidemiología a la neurobiología. Rev Neurol. 2010;51(6):347-359.

  10. Fujinami A, Ohta K, Obayashi H, Fui M, Hasegawa G, Nakamura N, et al. Serum brain-derived neurotrophic factor in patiens with type 2 Diabetes mellitus: relationship to glucose metabolism and biomarkers of insulin resistence. Clin Biochem. 2008;41:812-7.

  11. Krabbe KS, Nielsen AR, Krogh-Madsen R, Plomgaard P, Rasmussen P, Erikstrup C,et al. Brain-Derived neurotrophic factor (BNDF) and type 2 Diabetes mellitus. Diabetología. 2007;50:431-8.

  12. Ho N, Sommers MS, Lucki I. Effects of diabetes on hippocampal neurogenesis: links to cognition and depression. Neurosci Biobehav Rev. 2013;37(8):1346-62.

  13. Holt RIG, de Groot M, Golden SH. Diabetes and Depression. Curr Diab Rep. 2014;14(6):491.

  14. Dunstan DA, Scott N, Todd AK. Screening for anxiety and depression: reassessing the utility of the Zung scales. BMC Psychiatry. 2017;17:329.

  15. Zung WWK. A self-rating depression scale. Arch Gen Psychiatry. 1965;12:63-70.

  16. Sánchez CJ, Hipólito LA, Mugártegui SS, Yáñez GR. Estrés y depresión asociados a la no adherencia al tratamiento en pacientes con Diabetes mellitus tipo 2. Aten Fam.2016;23(2).

  17. Conde V, Escribá JA, Izquierdo J. Evaluación estadística y adaptación castellana de la escala auto aplicada para la depresión de Zung. Arch Neurobiol 1970;33:185-206.

  18. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Pshychol. 1988;56:893- 7.

  19. Guía de práctica clínica. Diagnóstico y tratamiento de los trastornos de ansiedad en el adulto. México; Secretaría de salud, 2010 [internet. Consultado el 18 de noviembre de 2017]. Disponible en: http:// www.cenetec.salud.gob.mx/descargas/gpc/CatalogoMaestro/ 392 IMSS 10 Ansiedad/EyR IMSS 392 10.pdf

  20. Anarte MT, Ruíz de Adana MS, Carreira M, Domínguez López M, Machado A, González Molero I, et al. Estudio longitudinal del impacto del tratamiento con infusores de insulina en variables psicológicas, la calidad de vida y el control glucémico de pacientes con Diabetes mellitus tipo1. Av Diabetol. 2010;26(2):112-8.

  21. Radojkovic J, Sikavic N, Bukumiric Z, Tadic M, Kostic N, Babic R. Improvement of Glycemic Control in Insulin-Dependent Diabetics with Depression by Concomitant Treatment with Antidepressants. Med Sci Monit 2016; 22:2133-2143.

  22. Guzmán PC, Baeza FG, Atilano JD, Torres LJ, León MO. Efectos de una intervención educativa sobre los parámetros bioquímicos de pacientes diabéticos de un servicio institucional. Aten Fam. 2017;24(2):82-83.

  23. Onyechi KC, Eseadi C, Okere AU, Onuigbo LN, Umoke PC, Anyaaegbunam NJ, et al. Effects of cognitive behavioral coaching on depressive symptoms in a simple of type 2 diabetic inpatients in Nigeria. Medicine (Baltimore). 2016,Aug;95(31).




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