Severe disability and self-reported depression and anxiety among persons living with Type 2 diabetes in Canada

This study aims to estimate the national prevalence of self-reported depression and anxiety disorders among persons living with Type 2 diabetes in Canada, as well as to investigate the potential link between disability severity and these conditions. We conducted a cross-sectional analysis of a subsample (N=8,321) of participants living with Type 2 diabetes in the 2017-2018 Canadian Community Health Survey-Annual Component. Modified Poisson regression models were used to examine the association between disability severity and depression and anxiety disorders. Descriptive statistics, prevalence estimates, adjusted relative risk, and 95% confidence intervals are reported. All statistical analyses were conducted using STATA version 18. The prevalence of depression and anxiety were 12.4% and 10.1% respectively. Our study found disability severity as a strong risk factor for both psychiatric disorders. We also found (1) dissatisfaction with life, (2) extremely stressful life events, (3) being female (4) single or never married, (5) poor self-rated health, (6) obesity, and (7) current smoker as significant risk factors for both psychiatric disorders. Conversely, increasing age and higher annual personal income status were significant protective factors. The study's limitations include the inability to establish temporal connections between risk factors and psychiatric disorders due to the cross-sectional design and the exclusion of those living in remote parts of the country and others from participation in the survey, which may underestimate the prevalence of Type 2 diabetes and severe disability. This study's findings point toward a growing demand for tertiary prevention to increase the probability for those living with Type 2 diabetes in Canada of maintaining functional health, improving mental health, and having a better quality of life. Public health prevention efforts targeted at decreasing the prevalence of diabetes and its complications and disability severity are recommended.