Relationship between socio-demographic, clinical and psychosocial variables in patients with Type 2 Diabetes

Elisabete Gomes Costa, Ricardo Pereira Campos, Eleonora Cunha Costa


The aim of this study is to analyze the relationship between socio-demographic, clinical and psychosocial variables in patients with Type 2 Diabetes and to establish comparative patterns between genders with this disorder.

Patients from a primary care center were assessed through a researcher design form and through the HADS, the ESSS and the PSQI.

A total of 90 patients with Type 2 Diabetes were enrolled in this study (50% women), with a mean age of 56.67±6.41 years. The HADS depression presented a score of 3.77±2.98 and 6.70% of the sample revealed depression symptoms. As to anxiety, the HADS presented scores of 7.27±5.07 with 36.60% of the subjects revealing anxiety symptoms. Regarding social support, the results were positive and similar between genders. When it comes to sleep, the sample presented a PSQI of 8.68±2.87, with 73.30% of patients revealing poor sleep quality and 24.40% showing a sleep disorder. When comparing genders, women had higher anxiety (♀ 9.73±5.58; ♂ 4.80±2.91; p=0.000) and depression scores (♀ 4.26±2.69; ♂ 3.26±3.19; p=0.026), and worse sleep quality (♀ 9.88±7.46; ♂ 7.46±2.34; p=0.000).

In conclusion, we can state that anxiety symptoms are very prevalent in patients with Type 2 Diabetes and women are more vulnerable to anxiety, depression symptoms and poor sleep quality.


Type 2 Diabetes; anxiety; depression; social support; sleep


Amorim, I. L., & Coelho, R. (2008). Diabetes Mellitus Tipo 2 e sintomas psicopatológicos. Psicologia, Saúde & Doenças, 9(2), 319-333.

Barone, M. T., & Menna-Barreto, L. (2011). Diabetes and sleep: a complex cause-and-effect relationship. Diabetes Res Clin Pract, 91(2), 129-137. doi: S0168-8227(10)00388-8 [pii]


Buysse, D. J., Reynolds, C. F., 3rd, Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res, 28(2), 193-213.

Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1986). The Pittsburgh Sleep Quality Index (PSQI): a new instrument for psychiatric research and practice. Psychiatry Research, 28(2), 193-213.

Collins, M. M., Corcoran, P., & Perry, I. J. (2009). Anxiety and depression symptoms in patients with diabetes. Diabet Med, 26(2), 153-161. doi: DME2648 [pii]


Collop, N. A., Adkins, D., & Phillips, B. A. (2004). Gender differences in sleep and sleep-disordered breathing. Clin Chest Med, 25(2), 257-268. doi: 10.1016/j.ccm.2004.01.002

S0272523104000164 [pii]

Cunha, M. C. B., Zanetti, M. L., & Hass, V. J. (2008). Sleep quality in type 2 diabetics. Revista Latino-Americana de Enfermagem, 16, 850-855.

Gellis, L. A., Lichstein, K. L., Scarinci, I. C., Durence, H. H., Raylor, D. J., Bush, A. J., & Riedel, B. W. (2005). Socioeconomic status and insomnia. Journal of Abnormal Psychology, 114(2), 111-118.

Goldney, R. D., Phillips, P. J., Fisher, L. J., & Wilson, D. H. (2004). Diabetes, depression, and quality of life: a population study. Diabetes Care, 27(5), 1066-1070.

Grandner, M. A., Patel, N. P., Gehrman, P. R., Xie, D., Sha, D., Weaver, T., & Gooneratne, N. (2010). Who gets the best sleep? Ethnic and socioeconomic factors related to sleep complaints. Sleep Med, 11(5), 470-478. doi: S1389-9457(10)00096-1 [pii]


Gucciardi, E., Wang, S. C., DeMelo, M., Amaral, L., & Stewart, D. E. (2008). Characteristics of men and women with diabetes: observations during patients' initial visit to a diabetes education centre. Can Fam Physician, 54(2), 219-227.

Jakab, Z. (2010). Delivering for Diabetes in Europe. Paper presented at the Plenary Meeting of the European Parliament’s EU Diabetes Working Group, Brussels, Belgium.

Khuwaja, A. K., & Kadir, M. M. (2010). Gender differences and clustering pattern of behavioural risk factors for chronic non-communicable diseases: community-based study from a developing country. Chronic Illn, 6(3), 163-170. doi: 1742395309352255 [pii]


Khuwaja, A. K., Lalani, S., Dhanani, R., Azam, I. S., Rafique, G., & White, F. (2010). Anxiety and depression among outpatients with type 2 diabetes: A multi-centre study of prevalence and associated factors. Diabetol Metab Syndr, 2, 72. doi: 1758-5996-2-72 [pii]


Knutson, K. L., Ryden, A. M., Mander, B. A., & Van Cauter, E. (2006). Role of sleep duration and quality in the risk and severity of type 2 diabetes mellitus. Arch Intern Med, 166(16), 1768-1774. doi: 166/16/1768 [pii]


Kuzuya, T., & Matsuda, A. (1982). Family histories of diabetes among Japanese patients with type 1 (insulin-dependent) and type 2 (non-insulin-dependent) diabetes. Diabetologia, 22(5), 372-374.

Nascimento, A. B., Chaves, E. C., & Grossi, S. A. A. (2009). Depressão, cortisol urinário e perfil sócio-demográfico de portadores de diabetes mellitus tipo 2. Revista da Escola de Enfermagem da USP, 43(2), 1272-1276.

Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric theory (3rd ed.). New York: McGraw-Hill.

Observatório Nacional da Diabetes. (2010). Diabetes: factos e números 2010 - Relatório anual do observatório nacional da Diabetes. Lisboa: Ministério da Saúde de Portugal.

Osborn, C. Y., & Egede, L. E. (2012). The relationship between depressive symptoms and medication nonadherence in type 2 diabetes: the role of social support. Gen Hosp Psychiatry, 34(3), 249-253. doi: S0163-8343(12)00030-8 [pii]


Pais-Ribeiro, J. L. (1999). Escala de Satisfação com o Suporte Social (ESSS). Análise Psicológica, 17(3), 547-558.

Pais-Ribeiro, J. L., Silva, I., Ferreira, T., Martins, A., Meneses, R., & Baltar, M. (2007). Validation study of a Portuguese version of the Hospital Anxiety and Depression Scale. Psychol Health Med, 12(2), 225-235.

Papelbaum, M., Appolinario, J. C., Moreira Rde, O., Ellinger, V. C., Kupfer, R., & Coutinho, W. F. (2005). Prevalence of eating disorders and psychiatric comorbidity in a clinical sample of type 2 diabetes mellitus patients. Rev Bras Psiquiatr, 27(2), 135-138.

Park, H., & Kim, M. T. (2012). Impact of social role strain, depression, social support and age on diabetes self-efficacy in Korean women with type 2 diabetes. J Cardiovasc Nurs, 27(1), 76-83. doi: 10.1097/JCN.0b013e318214d9d9

Peyrot, M. (2003). Depression: a quiet killer by any name. Diabetes Care, 26(10), 2952-2953.

Peyrot, M., & Rubin, R. R. (1999). Persistence of depressive symptoms in diabetic adults. Diabetes Care, 22(3), 448-452.

Rajendran, A., Parthsarathy, S., Tamilselvan, B., Seshadri, K. G., & Shuaib, M. (2012). Prevalence and correlates of disordered sleep in southeast asian indians with type 2 diabetes. Diabetes Metab J, 36(1), 70-76. doi: 10.4093/dmj.2012.36.1.70

Ramos, L., & Ferreira, E. A. P. (2011). Fatores emocionais, qualidade de vida e adesão ao tratamento em adultos com Diabetes Tipo 2. Revista Brasileira de Crescimento e Desenvolvimento Humano, 21(3), 867-877.

Ricco, R. C., Miyazaki, M. C. O. S., & Silva, R. C. M. A. (2004). Depressão em pacientes adultos portadores de doenças crónicas: diabetes mellitus e hepatites virais. Arquivos de Ciências da Saúde, 7(9), 156-160.

Roth, T. (2008). Novel outcome measures of sleep, sleep loss and insomnia. Sleep Med, 9 Suppl 1, S1-2. doi: S1389-9457(08)70009-1 [pii]


Roupa, Z., Koulouri, A., P, S., Makrinika, E., Marneras, X., Lahana, I., & Gourni, M. (2009). Anxiety and depression in patients with type 2 diabetes mellitus, depending on sex and body mass index. Health Science Journal, 3(1), 32-40.

Schiotz, M. L., Bogelund, M., Almdal, T., Jensen, B. B., & Willaing, I. (2012). Social support and self-management behaviour among patients with Type 2 diabetes. Diabet Med, 29(5), 654-661. doi: 10.1111/j.1464-5491.2011.03485.x

Sekine, M., Chandola, T., Martikainen, P., McGeoghegan, D., Marmot, M., & Kagamimori, S. (2006). Explaining social inequalities in health by sleep: the japanese civil servants study. Journal of Public Health (Oxford), 28(1), 63-70.

Snaith, R. P., & Zigmond, A. S. (1994). HADS: Hospital Anxiety and Depression Scale. Windsor: NFER Nelson.

Tellez-Zenteno, J. F., & Cardiel, M. H. (2002). Risk factors associated with depression in patients with type 2 diabetes mellitus. Arch Med Res, 33(1), 53-60.

Valdez, R., Yoon, P. W., Liu, T., & Khoury, M. J. (2007). Family history and prevalence of diabetes in the U.S. population: the 6-year results from the National Health and Nutrition Examination Survey (1999-2004). Diabetes Care, 30(10), 2517-2522. doi: dc07-0720 [pii]


Vigg, A. (2003). Sleep in Type 2 diabetes. J Assoc Physicians India, 51, 479-481.

Walsh, J. K. (2004). Clinical and socioeconomic correlates of insomnia. Journal of Clinical Psychiatry, Suppl. 659(8), 13-19.

Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatr Scand, 67(6), 361-370.

Zimmernan, B. R., & Walker, E. A. (2002). Guia completo sobre Diabetes. Rio de Janeiro: Anima Editora.



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