SA JOURNAL OF DIABETES & VASCULAR DISEASE RESEARCH ARTICLE VOLUME 21 NUMBER 1 • November 2024 25 The HbA1c control was independently associated with older (p = 0.002) patients, claims for statins, and being diagnosed with MDD (p < 0.0001). In Table 4, a stepwise multivariate logistic regression analysis identified predictors of LDL-C control of the T2DM + MDD versus T2DM – MDD groups. Significant contributing factors to LDL-C control between the two groups were being older (p < 0.0001) and claiming statins (p = 0.001). Fig. 2 exhibits the percentage of patients with T2DM + MDD on SSRIs reaching HbA1c levels of < 7%. There was no statistically significant difference in the proportion of patients achieving HbA1c target regardless of the nature of their antidepressant therapy. After performing a multiple logistic regression in patients with T2DM + MDD, SSRIs (p = 0.19) and metformin (p = 0.27) were not independently associated with HbA1c control when adjusted for age and gender. There was a significant difference in the macrovascular hospitalisations between the T2DM + MDD and T2DM – MDD groups (Table 5). A higher proportion of patients in the T2DM + Table 2. Clinical profile of patients with T2DM + MDD, T2DM – MDD and MDD achieving targets Clinical characteristics T2DM+MDD T2DM–MDD MDD control HbA1c (%) n = 223 n = 656 n = 332 HbA1c, median (IQR) 7.4 (6.0–8.2) 7.2 (6.2-8.5) # 5.4 (5.2-5.8)** HbA1c < 7%, n (%) 125/223 (56) # 295/656 (45) – HbA1c < 7%, median (IQR) 6.1 (5.7–6.6) 6.2 (5.8–6.5) – TC (mmol/l) n = 217 n = 520 n = 278 TC, median (IQR) 4.4 (3.6–5.3) 4.3 (3.6–5.1) 5.1 (4.3–5.8)** TC < 4.5 mmol/l, n (%) 118/217 (54) 298/520 (57) 83/278 (30)** LDL-C (mmol/l) n = 220 n = 519 n = 268 LDL-C, median (IQR) 2.4 (1.8–3.1) 2.4 (1.8–3.1) 3.0 (2.4–3.8)** LDL-C < 1.8 mmol/l, n (%) 52/220 (24) 125/519 (24) – LDL-C < 1.8 mmol/l, median (IQR) 1.4 (1.1–1.6) 1.5 (1.2–1.6) – HDL-C (mmol/l) n = 215 n = 507 n = 139 HDL-C, median (IQR) 1.1 (0.9–1.4) 1.1 (0.9–1.3) 1.3 (1.1–1.6)** HDL-C ≥ 1 mmol/l (male); ≥ 1.2 mmol/l (female), n (%) 129/215 (60) 328/507 (65) 118/139 (85)** Triglycerides (mmol/l) n = 216 n = 508 n = 266 Triglycerides, median (IQR) 1.70 (1.3–2.3) 1.7 (1.2–2.6) 1.3 (0.9–1.9)** Triglycerides < 1.7 mmol/l, n (%) 99/216 (46) 255/508 (50) 177/266 (67)** BP (mmHg) n = 181 n = 451 n = 107 SBP, mean ± SD 132 ± 17 134 ± 17 135 ± 17 DBP, mean ± SD 79 ± 12# 82 ± 12 83 ± 12 SBP ≤ 140 mmHg, n (%) 135/181 (75) 340/451 (75) 78/107 (73) BP, blood pressure; HbA1c, glycated haemoglobin; HDL, high-density lipoprotein cholesterol; IQR, interquartile range; LDL-C, low-density lipoprotein cholesterol; MDD, major depressive disorder; TC, total cholesterol; T2DM, type 2 diabetes mellitus. *p < 0.01 and **p < 0.001 between the three groups; #p < 0.05 between T2DM with and without MDD groups. Table 3. Stepwise multivariate logistic regression of HbA1c control in T2DM + MDD and T2DM – MDD groups Variables OR* 95% CI p-value Age 1.02 1.01–1.04 0.002 Statins claimed 2.09 1.41–3.11 < 0.0001 Metformin claimed 0.51 0.27–0.97 0.040 Newer hypoglycaemic agents claimed 0.45 0.21–0.99 0.048 MDD diagnosis 2.30 1.47–3.61 < 0.0001 *Adjusted for claims for antihypertensive agents, gender and the interaction factor of newer hypoglycaemic agents and metformin. Fig. 1. Percentage of patients with T2DM with and without MDD achieving ABC (HbA1c, SBP and LDL-C) goal. HbA1c, glycated haemoglobin; LDL-C, low-density lipoprotein cholesterol; MDD, major depressive disorder; T2DM, type 2 diabetes mellitus; SBP, systolic blood pressure.
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