Coping interventions for depression in patients with Type 2 Diabetes Mellitus

Abstract

Introduction: Type 2 diabetes mellitus (T2DM) and depression are serious chronic diseases that often coexist. Depression is almost twice as common in people with DM2 as in the general population. When both conditions are present, they are associated with worse glycemic control, poorer self-care, reduced quality of life, increased risk of complications, and increased mortality. Despite its importance, a significant number of patients with T2DM and depression remain untreated or even diagnosed. There is a lack of studies and management guidelines on the simultaneous treatment of these two conditions.

Objectives: This literature review aims to analyze the different coping interventions against depression in patients with DM2 with the purpose of having a complete overview of the available treatment options and identifying the most effective strategies. In addition to identifying the factors that predispose patients with DM2 to develop depression.

Methodology: A bibliographic review of meta-analyses, randomized clinical trials and systematic reviews published between 2018 and 2024 was carried out, obtained from databases such as PubMed, Google Scholar and Scopus. Risk factors, different coping interventions against depression, their definitions, effectiveness and modes of application supported by scientific evidence were identified. The most relevant articles were selected and the most significant information was classified.

Main results: The main risk factors for developing depression in patients with DM2 include biological aspects (hyperglycemia, vascular damage, complications), behavioral (lifelong treatment, obesity, physical inactivity, sleep disturbances), socioeconomic (low socioeconomic status, expenses on medication, social instability, low educational level), environmental and psychological. The most effective interventions to deal with depression in patients with T2DM are cognitive-behavioral therapy (CBT), group CBT, exercise, pharmacological treatment (SSRI) and online treatment. To improve both depression and glycemic control, pharmacotherapy and the combination of CBT with exercise stand out. Selection of the most appropriate intervention should consider the severity of depressive symptoms, patient preferences, available resources, effectiveness, and possible effects on glycemic control. The tiered models provide a useful guide for this selection