Медицинский совет (May 2020)
Daytime sleepiness, depression and obesity in patients with type 2 diabetes mellitus of different sexes as a drug target
Abstract
Introduction. Patients with type 2 diabetes are more likely to have concomitant depression. In addition, there are some studies that have alluded to a direct relationship between overweight and diabetes and daytime drowsiness.The aim of this study was to study the relationship of metabolic disorders, anthropometric data with daytime sleepiness and depression in patients with type 2 diabetes.Material and methods. A general clinical study consisted in interviewing the patient (complaints, medical history), obtaining physical data (anthropometry) – height (cm), weight (kg), neck circumference (cm), waist circumference (cm), hip circumference (cm). The object of the study was the whole blood and blood plasma of patients in order to determine the level of fasting plasma glucose, glycosylated hemoglobin and other blood biochemical parameters. To verify violations in the emotional-volitional sphere, the Beck Depression Inventory and the Epworth Sleepiness Scale were used.Results. All patients had visceral obesity, the waist circumference is significantly higher than normal, both in men and women. In accordance with the Epworth drowsiness scale, on average, borderline insomnia was recorded in the examined patients with type 2 diabetes. Drowsiness rate correlated with waist circumference (r = 0,65) and hips (0,67), age (0.34) only in male patients. The level of depression correlated with age in female patients (r = 0.37, p < 0,05) and male (r = 0,6, p < 0,05) and did not correlate with drowsiness in both groups. The level of depression was 16, which corresponds to mild to moderate depression. However, the rate of depression is negligible, but higher among female patients (14.00 [6.00; 18.00] versus 19.00 [10.50; 20.00], p = 0,047).Conclusions. Increased daytime sleepiness and depression accompany patients with type 2 diabetes, regardless of gender. The dependence between the severity of decreased daily activity and increased anthropometric indicators and age can be seen in male patients, which may illustrative of increasing androgen deficiency in men and its contribution to the development of metabolic disorders, including obesity. Depressive states have deeper manifestations in female patients with type 2 diabetes compared to male patients, which may indicate both emotional instability of female patients and a more pronouncedeffect of the disease itself on the psychoemotional background in women.
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