Clinical variables associated with depression in patients with type 2 diabetes.

BACKGROUND: the aim of the study was to evaluate the relationship between type 2 diabetes (T2DM), depression and depressive symptoms and their clinical impact on T2DM. METHODS: the authors evaluated 214 outpatients, 105 with diabetes (T2DM group) and 109 non-diabetics (control group), with ages ranging between 50 and 75 years (T2DM group 65.1 ± 5.6 years, control group 63.4 ± 5.8 years). Use of antidepressant treatment or score ≥ 16 on the Beck depression inventory (BDI) was considered depression. Complications of diabetes and total symptom score (TSS) for peripheral neuropathy were reported by patients. RESULTS: diabetes group had a higher frequency of depression (35.2%) compared to controls (21.1%) (p=0,021), with 2.4 times increased risk of depression. The presence of depressive symptoms was also higher in T2DM group (mean BDI 9.5 ± 8.8 versus 6.9 ± 6.2; p=0.039). Symptoms of diabetic neuropathy were higher in depressed subjects. The metabolic control and presence of complications in T2DM group were not associated with depression. CONCLUSION: T2DM led to an increased risk of depression, but this did not influence the metabolic control or the presence of other complications.

Clinical variables associated with depression in patients with type 2 diabetes / Características clínicas associadas à depressão em pacientes com diabetes tipo 2

SummaryBackground:the aim of the study was to evaluate the relationship between type 2 diabetes (T2DM), depression and depressive symptoms and their clinical impact on T2DM.Methods:the authors evaluated 214 outpatients, 105 with diabetes (T2DM group) and 109 non-diabetics (control group), with ages ranging between 50 and 75 years (T2DM group 65.1 ± 5.6 years, control group 63.4 ± 5.8 years). Use of antidepressant treatment or score ≥ 16 on the Beck depression inventory (BDI) was considered depression. Complications of diabetes and total symptom score (TSS) for peripheral neuropathy were reported by patients.Results:diabetes group had a higher frequency of depression (35.2%) compared to controls (21.1%) (p=0,021), with 2.4 times increased risk of depression. The presence of depressive symptoms was also higher in T2DM group (mean BDI 9.5 ± 8.8 versus 6.9 ± 6.2; p=0.039). Symptoms of diabetic neuropathy were higher in depressed subjects. The metabolic control and presence of complications in T2DM group were not associated with depression.Conclusion:T2DM led to an increased risk of depression, but this did not influence the metabolic control or the presence of other complications.

ResumoObjetivo:avaliar a relação entre diabetes mellitus tipo 2 (DM2), depressão e sintomas depressivos e seu impacto no controle clínico do DM2.Métodos:foram avaliados 214 pacientes ambulatoriais, 105 com DM2 e 109 não diabéticos, com idade entre 55 e 75 anos (grupo DM2 65,1±5,6 anos e grupo controle 63,4±5,8 anos). Considerou-se depressão o uso de tratamento antidepressivo ou escore ≥16 no inventário de Beck (BDI). Complicações do DM2 e escore total de sintomas (TSS) para neuropatia periférica foram questionados aos pacientes.Resultados:o grupo DM2 apresentou maior frequência de depressão (35,2%) em relação aos controles (21,1%) (p=0,021), com um risco 2,4 vezes maior de apresentar depressão. A presença de sintomas depressivos também foi superior no grupo DM2 (média BDI 9,5±8,8 versus 6,9±6,2; p=0,039). Os sintomas de neuropatia diabética foram superiores nos depressivos. O controle metabólico e a presença de complicações no grupo DM2 não foram associados à depressão.Conclusão:o DM2 determinou um maior risco de depressão; porém, essa associação não influenciou o controle metabólico e a presença de outras complicações da doença.

Acute renal failure provoked by toxin from caterpillars of the species Lonomia obliqua.

Acute renal failure (ARF) is a complication of envenoming by contact with caterpillars of the species Lonomia obliqua. A cohort study was conducted to evaluate development of acute and chronic renal failure (CRF) in patients who been in contact with L. obliqua during the period from 1989 to 2003 in the State of Santa Catarina, southern Brazil. Patients were evaluated in two distinct groups: those prior to 1995, who did not receive specific treatment of any type, and those after this date who were treated with antilonomic serum (SALon). The presence of creatinine > or = 1.5 mg/dl in patients who had no history of previous renal illness was considered to be indicative of acute kidney failure. Of the 2067 patients evaluated, 39 (1.9%) developed ARF. Eleven (32%) of these patients were treated with dialysis and four (10.3%) developed CRF. The seven deaths (4%) occurred in the period before treatment with SALon. Blood coagulation measures (TC, TP, and TTPA), were significantly longer in the group with ARF. All patients with ARF and 67% of the control group presented hematuria. The majority of the patients recovered prior renal function, however, four (10.3%) needed chronic dialysis. Envenoming by L. obliqua can be considered an important risk factor for the development of potentially fatal ARF, as well as for developing CRF.