Anxiety profile in patients with type 2 diabetes, the relationship of anxiety with diabetes regulation and vitamin D

Introduction: Type 2 Diabetes Mellitus (T2DM), one of the most common metabolic disorders, is a common chronic disease and the rate of comorbidity of anxiety is higher than the general population. Despite this, the current situation can be overlooked and its treatment can be skipped. This situation may adversely affect the treatment process of the patient for diabetes. In this study, it was aimed to detect anxiety levels in T2DM patients and to evaluate the effect of blood glucose regulation and vitamin D level on anxiety. Material-method: In our study, 69 patients with Type 2 Diabetes Mellitus without comorbidity and 70 healthy controls were included in the age range of 18-65 years. Those with acute or chronic diseases other than Type 2 Diabetes Mellitus, pregnant women, those with a history of psychological trauma in the last 6 months, and those with a history of Vitamin D and psychogenic drug use in the last 6 months were not included in the study. In the research, a questionnaire consisting of Sociodemeographic Particular Form, Clinical Data Form and Depression Anxiety Stress Scale was used as data collection tool. Descriptive statistics, chi-square test, Fisher's exact chi-square test, Spearman and Pearson correlation analysis, Mann Whitney U test, Kruskal Wallis analysis of variance were used in statistical analysis. Binary Logistic Regression Analysis was performed by determining the independent risk factors between the diagnosis of Type 2 DM and the control group by chi-square and Whitney U test. Significance level was accepted as p<0.05. Necessary permissions and ethical approval were obtained for the research. Results: A total of 139 people, 69 of whom were diagnosed with Type 2 diabetes in the case group and 70 in the control group, participated in our study. The mean age of Type 2 diabetes patients participating in the study was 51.67±8.48 years and 53.62% were women. In the study, it was observed that 36.23% of the diabetic patients had regulated HbA1c levels (<7%) and 12.9% had sufficient vitamin D levels. There was no statistically significant difference between anxiety levels of Type 2 diabetes patients who participated in the study, according to their HbA1c levels being regulated. However, considering all the participants included in the study, the HbA1c level of those with normal anxiety levels was determined to be lower than those with mild to severe anxiety. A positive, moderate, statistically significant correlation was found between anxiety and HbA1c levels. There was no significant difference between anxiety levels according to vitamin D levels of the patients participating in the study (p>0.05). In the study, the glucose level of the participants whose anxiety level was mild-very advanced was found to be statistically significantly higher (p<0.01). Of all the participants, those with a vitamin D level below <10 had a higher than normal anxiety level compared to those with a Vitamin D level above 10 (p<0.05). Vitamin D those with a level below 10 had a significantly higher glucose level than those with a level between 10-20 and more than 20 (p<0.01). Vitamin D levels of participants with HbA1c below 7 were found to be statistically significantly higher than those with HbA1c between 7-10 (p<0.01). According to the Depression Anxiety Stress Scale, 23% of the diabetic patients were found to be normal, 16.5% mild anxiety, 4.3% moderate anxiety, 5.8% severe-very severe anxiety. Anxiety levels and scores of diabetic patients were significantly higher than the healthy control group (p<0.01). Conclusions: Anxiety is more common in diabetic patients. In addition, vitamin D deficiency is more pronounced. Therefore, patients with T2DM should be considered in both aspects in their outpatient clinic controls. With studies to understand both vitamin D and the causes of anxiety in diabetic patients, intervention areas can be determined in this regard. Keywords: Diabetes Mellitus, Vitamin D, Anxiety, DASS-21, Depression