PSYCHOSOCIAL DETERMINANTS OF TYPE 2 DIABETES MELLITUS

Diabetes Mellitus type 2 , formerly non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes, is a metabolic disorder that is characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency1. The development of Diabetes Mellitus type 2 is associated with multiple risk factors, co-morbid medical conditions as well as psychosocial determinants. These psychosocial factors, which differ from population to population, can be identified and controlled to reduce the incidence of type 2 Diabetes Mellitus. Objective: To identify various psychosocial factors associated with type 2 Diabetes Mellitus. Design: Case-control study. Place Duration: Diabetic clinic and Medical Units Mayo Hospital Lahore . July to December, 2012. Subjects Methods: A population based case-control study with 1:1 case to control ratio was conducted. A total of 100 subjects (50 cases and 50 controls) having age above 35 years were recruited in the study. Selection was made on laid down criteria from patients coming to Mayo Hospital Lahore after taking consent. Interviews were conducted through a pretested questionnaire. Data was collected, compiled and analyzed through IBM SPSS version 20. Results: Out of 100 study subjects 67% were males and 33% were females. Among cases of Diabetes mellitus type 2, 64% were males, 70% in the age group 35-50 years, 96% were married, 36% were illiterates. Mean age was found 49.24, standard deviation 10.915. In bivariate analysis, Diabetes Mellitus type II was found significantly associated with Anxiety(OR: 5.348, 95% CI: 2.151-13.298) Depression(OR: 5.063, 95% CI: 1.703-15.050), High fat diet, (OR: 2.471, 95% CI: 1.100-5.547) Sedentary Lifestyle(OR: 4.529, 95% CI: 1.952-10.508) and Psychological Stress(OR: 4.529, 95% CI: 1.952-10.508).However, in multivariate analysis while controlling all other risk factors, Anxiety(OR: 6.066, 95% CI: 1.918-19.191), High fat diet(OR: 3.648, 95% CI: 1.265-10.522), Overeating(OR: 3.196, 95% CI: 1.127-9.064) and Psychological Stress(OR: 3.071, 95% CI: 1.151-8.188) were found significant. Conclusion: The type 2 Diabetes Mellitus was significantly associated with Anxiety, High fat diet intake, Overeating and Psychological stress.