PSYCHOSOCIAL DETERMINANTS TO GLYCEMIC CONTROL AMONG DIABETIC ADULTS ATTENDING ARMED FORCES HOSPITAL SOUTHERN REGION.

Background: Although there are some international and regional prevalence studies on psychological issues in diabetic patients, there is a paucity of epidemiological estimates on the prevalence, characterization and risk factors of depression, anxiety and stress among diabetics in Saudi Arabia. Objectives: To find out the magnitude of depression, anxiety, stress symptoms and some social factors among diabetic patients with their predictions and association to glycemic control. Subjects and methods A case-control study was implemented at AhadRufaidah, Southern Region, Saudi Arabia where the glycemic uncontrolled patients (cases) were compared to those who were controlled (controls) regarding the prevalence of psychological symptoms and other related social and demographic factors.A consecutive sample of adult diabetic patients registered at the diabetic centers in armed forces hospital was chosen. Participants were classified into two groups, i.e., glycemic uncontrolled patients group and controlled glycemic group.A self-administered questionnaire was developed and used for collection of data. It includes personal characteristics diabetes-related variables and the Arabic version of the Depression, Anxiety, and Stress Scale (DASS-21). Results: The study included 395 patients. Their age ranged between 18 and 90 years with a mean±SD of 53.9±13.1 years Most of them were males (70.1%). Depression was reported among more than half of the participants (51.9%) whereas anxiety and depression were reported among 70.1% and 37.7% of them, respectively. Glycated hemoglobin level was not significantly associated with depression, anxiety or stress. Among studied demographic and social factors, only marital status and smoking history were significantly associated with glycemic control. Single patients were more likely to have uncontrolled diabetes compared to married patients (95.2% versus 65.3%), p=0.025. Smokers were more likely to have uncontrolled diabetes compared to non-smokers (87.5% versus 65.6%), p=0.007. Conclusion: There is evidence of high co-morbidity of diabetes and depression, anxiety and stress symptoms in Saudi Arabia. However, glycemic control according to HBA1c level was not associated with psychological issues in diabetic patients.