Salma Bensbaa1, Chadya Araab2, Saïd Boujraf3, Farida Ajdi1. 1. Department of Endocrinology, Diabetology and Nutrition, University Hospital of Fez, Morocco. 2. Department of Psychiatry, University of Fez, Morocco ; Clinical Neuroscience Laboratory, Faculty of Medicine, University of Fez, Morocco. 3. Clinical Neuroscience Laboratory, Faculty of Medicine, University of Fez, Morocco ; Department of Biophysics and Clinical MRI Methods, Faculty of Medicine, University of Fez, Morocco.
Sir,Diabetespatients are more exposed to depression. This association might yield higher rates of mortality, morbidity and costs of health-care.[1] The world evaluation of depression prevalence in diabetespatients seems to vary according to the prosperity and health-care system of each country.[2] Hence, what are the factors of impact on the gap of depression rate within type 2 diabetes (T2D) in developing and developed countries? What are the care possibilities to reduce the depression rate in developing countries compared with developed countries?To answer this question, we achieved a transversal study in the University Hospital of Fez, Morocco. The study included 142 T2D patients.The average age of patients was 56.68-year-old, without significant difference in gender ration. The depression prevalence in our patients was 33.1%. Factors connected to the depression of MoroccanT2D are summarized in Table 1.
Table 1
Risk factors related to depression in Moroccan T2D patients
Risk factors related to depression in Moroccan T2D patientsThe prevalence of T2D was significantly higher compared with the general population. It varies between 12% and 44%. Indeed, the prevalence of T2D is lower in western countries; it is elevated in developing countries.[34]The literature review revealed that depression of T2D patients is mostly associated to unchangeable factors such as the duration of evolution and arterial hypertension, which are common factors in developed and developing countries.[3]Besides, depression of T2D patients is strongly connected the low educational level of patients, a lack of social security. These two factors are dominant in developing countries.[5]Indeed, in developing countries factors such as lack of social, lower educational level, strong poverty level and resources and financial difficulties constitute the economical outline of stress responsible for insecurity feeling toward chronic disease such T2D.Furthermore, the health-care of T2D patients might require referencing the patients to specialist that might be involved including psychiatrists, which are not available geographically within joint distance for many patients.Therefore, we do consider the challenge of treatment approach of T2D patients. It is necessary to integrate diabetes within a framework of biopsychosocial and political approach.We suggest integrating T2D patient in coordinated multidisciplinary strategy of health-care. This should include a health-care staff sensitive to the screening and managing the psychological state T2D patients and risk factors of the depression. This could be achieved through improving the general life condition including eradicating illiteracy and generalizing the social security for forward improvement of access to health-care.