Prevalence and Risk Factors of Depression in Patients with Diabetes Mellitus: A Systematic Review and Meta-Analysis

Abstract

Objective: This systematic review and meta-analysis examined the prevalence of depression among individuals with diabetes and identified associated risk factors.

Methods: Five databases (PubMed, Web of Science, Cochrane, ProQuest, Embase) were searched for observational studies reporting depression prevalence and multivariable-adjusted risk factors in diabetic populations. Two reviewers independently screened and extracted data. Analyses were conducted using R software.

Results: Thirty-nine studies involving 17,486 diabetic patients were included. The pooled prevalence of depression was 35% (95% CI: 30%–41%). Risk factors included age ≤60 years, female sex, being single, unemployment, physical inactivity, anxiety, limited social support, poor medication adherence, complications (neuropathy, nephropathy, retinopathy, foot ulcers), physical disability, insulin therapy, combined insulin–oral treatment, and fasting glucose ≥126 mg/dL.

Conclusion: Depression affects over one-third of diabetic patients and is associated with sociodemographic, psychological, and clinical factors. Routine screening and timely intervention are essential, especially for high-risk groups. Longitudinal studies are needed to clarify causal links and inform targeted prevention.

Code

This document primarily presents R code for conducting a meta-analysis on the prevalence and risk factors of depression among patients with diabetes. The contents are organized into five sections: prevalence, subgroup analysis, analysis of influencing factors, sensitivity analysis, and meta-regression. Each section provides complete, executable code, which can be directly run to generate the corresponding forest plot.