(074) The Prevalence of Depression among Patients with Type 2 Diabetes: An Umbrella Review

Background: Patients with type 2 diabetes (T2D) have a higher risk to experience depression, but reported prevalence varies.

Objectives: This umbrella review aims to explore differences in reported depression prevalence among patients with type 2 diabetes and to identify the factors contributing to the variation.

Methods: A literature search was conducted in PubMed, EMBASE, PsycINFO and Cochrane on 17 May 2023. We included systematic reviews investigating the prevalence of depression in adults (18 years old or older) with T2D. We followed the PRISMA guidelines and extracted data from the systematic reviews and from primary studies. The latter were analyzed using random-effect meta-analyses.

Results: A total of 23 systematic reviews with 649 unique primary studies met the inclusion criteria. The pooled prevalence reported in the systematic reviews ranged from 8.9 to 61.6%, and heterogeneity was large (I2 values ranged from 89.41% to 99.96%). The prevalence of depression among individuals with T2D varied significantly by WHO region and diagnostic instrument used. Studies conducted in the Eastern Mediterranean (0.192, CI 0.15-0.24), Africa (0.105, CI 0.04-0.17) and South-East Asia (0.09, CI 0.04-0.14) had higher prevalence compared to the Americas. Difference between Americas, Europe and Western Pacific were not significant. Compared to clinical diagnosis, studies using the self-reporting Beck Depression Inventory (BDI) or other methods for diagnosis had higher prevalence, (0.17, CI 0.09-0.24 and 0.19, CI 0.02-0.16, respectively).

Conclusions: Depression prevalence was high among people with T2D. Substantial variation was found in the prevalence of depression among individuals with T2D, depending on the region and the diagnostic instrument used. This could be due to the variance in healthcare infrastructure across the regions or to diverse criteria employed by instruments used to assess depression, as well as to true underlying differences in prevalence. These findings inform psychiatric, diabetes care practices, and health policymaking the necessity of implementing policies that encourage interdisciplinary collaboration with mental health services in managing diabetes patients.