Association between psychological distress and gastrointestinal symptoms in diabetes mellitus

AIM:To examine the possible association between gastrointestinal symptoms and anxiety and depression in type 2 diabetes mellitus(T2DM).METHODS:The study was a matched case-control study based on a face to face interview with designed diagnostic screening questionnaires for gastrointestinal(GI) symptoms and T2DM,Patient Health Questionnaire(PHQ-9) for depression and General Anxiety Disorders(GAD-7) for anxiety.The questionnaire consisted of questions about symptoms and signs of anxiety and depression disorders.Also,socio-demographic characteristics,life style habits and the family history of patients were collected.It was carried out from June 2010 to May 2011 among Qatari and other Arab nationals over 20 years of age at Primary Health Care Centers of the Supreme Council of Health,Qatar,including patients with diabetes mellitus and healthy subjects over 20 years of age.RESULTS:In the studied sample,most of the studied T2DM patients with GI symptoms(39.3%) and healthy subjects(33.3%) were in the age group 45-54 years(P < 0.001).The prevalence of severe depression(9.5% vs 4.4%,P < 0.001) and anxiety(26.3% vs 13.7%,P < 0.001) was significantly higher in T2DM patients with GI symptoms than in general population.Obesity(35.7% vs 31.2%) and being overweight(47.9% vs 42.8%) were significantly higher in T2DM patients with GI symptoms than in healthy subjects(P = 0.001).Mental health severity score was higher in T2DM patients with GI symptoms than in healthy subjects;depression(8.2 ± 3.7 vs 6.0 ± 3.6) and anxiety(7.6 ± 3.3 vs 6.0 ± 3.7).The most significant GI symptom which was considerably different from controls was early satiety [odds ratio(OR) = 10.8,P = 0.009] in depressed T2DM patients and loose/watery stools(OR = 2.79,P = 0.029) for severe anxiety.Anxiety was observed more than depression in T2DM patients with GI symptoms.CONCLUSION:Gastrointestinal symptoms were significantly associated with depression and anxiety in T2DM patients,especially anxiety disorders.

Parental transmission of type 2 diabetes mellitus in a highly endogamous population

AIM: To determine the parental transmission of diabetes mellitus (DM) and evaluate its influence on the clinical characteristics. METHODS: This was a cross sectional study. The survey was carried out in urban and semi-urban primary health care centers. Of the 2400 registered with diagnosed diabetes, 1980 agreed and gave their consent to take part in this study, thus giving a response rate of 82.5%. Face to face interviews were conducted using a structured questionnaire followed by laboratory tests. DM was defined according to the World Health Organization expert group. A trained nurse performedphysical examinations and measurements. RESULTS: Of the study population, 72.9% reported a family history of DM. Family history of DM was significantly higher in females (54.2%; P = 0.04) and in the age group below 30 years (24%; P < 0.001). The prevalence of diabetes was higher among patients with a diabetic mother (25.4% vs 22.1%) and maternal aunts/uncles (31.2% vs 22.2%) compared to patients with a diabetic father and paternal aunts/ uncles. Family history of DM was higher in patients of consanguineous parents (38.5%) than those of non-consanguineous parents (30.2%). The development of type 2 diabetes mellitus (T2DM) complications was higher in patients with either a paternal or maternal history of DM than in those without. No significant difference was observed in the metabolic characteristics of patients with/without family history of DM except for hypertension. Complications were higher in diabetic patients with a family history of DM. CONCLUSION: The present study found a significant maternal effect in transmission of T2DM. Family history is associated with the increased incidence of diabetes.