Comorbid Depression in Youth with Type 2 Diabetes Mellitus: Prevalence and Influencing Factors
Overview
This systematic review and meta-analysis of 17 studies including 5,215 pediatric and adolescent patients with type 2 diabetes mellitus (T2DM) found a pooled depression prevalence of 23.1%. Prevalence varied significantly by glycemic control and depression assessment method, highlighting important heterogeneity sources.
Background
The incidence of T2DM in children and adolescents is rising globally, driven by obesity and lifestyle changes, with significant metabolic and psychological consequences. Depression is a common comorbidity in this population, adversely affecting diabetes management and quality of life. However, reported depression prevalence rates vary widely due to methodological differences and population heterogeneity. Understanding the true burden and factors influencing depression prevalence is critical for improving clinical outcomes in youth with T2DM.
Data Highlights
Parameter
Value
Number of studies included
17
Total participants
5,215
Pooled prevalence of depression
23.1% (95% CI: 18.0%–29.1%)
Heterogeneity (I²)
93%
Prevalence by HbA1c <7%
52.0%
Prevalence by HbA1c ≥7%
24.0%
Prevalence by self-report scales
25.2%
Prevalence by clinical diagnostic criteria
12.2%
Key Findings
Approximately one in four youth with T2DM experience comorbid depression (23.1%).
Depression prevalence is significantly higher in patients with better glycemic control (HbA1c <7%) at 52.0% compared to those with HbA1c ≥7% (24.0%).
Studies using self-reported depression scales report higher prevalence (25.2%) than those using clinical diagnostic interviews (12.2%).
Substantial heterogeneity exists across studies (I² = 93%), influenced by glycemic control and depression assessment methods.
Depression in youth with T2DM negatively impacts diabetes self-care and overall clinical outcomes.
Clinical Implications
Clinicians should be aware that depression affects a significant proportion of pediatric and adolescent patients with T2DM, particularly those with better glycemic control, possibly reflecting increased psychological burden despite metabolic status. Standardized depression screening using validated diagnostic tools is essential to accurately identify affected individuals. Early psychological assessment and intervention can improve both mental health and diabetes management outcomes in this vulnerable population.
Conclusion
Depression is a common and clinically significant comorbidity in youth with T2DM, with prevalence influenced by glycemic control and assessment methods. These findings emphasize the need for routine, standardized mental health screening and integrated care approaches to optimize outcomes.
