Depression, poor sleep quality, and diabetic control in type 2 diabetes patients at Sunyani Regional Hospital, Ghana: a case–control study

Background: Diabetes patients are at risk of developing mental health comorbidities such as depression and poor quality of sleep. These conditions can affect diabetic management, including glycemic and plasma lipid control to optimal levels. We investigated the association between diabetic control and the presence of depression and poor sleep quality in type 2 diabetes (T2DM) patients at Sunyani Government hospital in Ghana. Using a case–control design, we recruited 200 T2DM patients and compared them to 160 non-diabetic controls. The presence of depression was assessed using the Patient Health Questionnaire (PHQ)-9 and sleep quality using the Pittsburgh Sleep Quality Instrument (PSQI). Blood samples were collected to measure glycated hemoglobin (HbA1c) levels and plasma lipid profiles. Poor glycemic control was defined as HbA1c > 7%, depression as PHQ-9 score > 9 and poor sleep quality as PSQI score ≥ 5. Results: T2DM patients had a higher prevalence of depression (31.5% vs 10.6%, p < 0.001) and poor sleep quality (64% vs 40%, p < 0.001) compared to non-diabetic controls. Glycemic control was not associated with depression and poor sleep quality in T2DM patients. Depression was associated with increased odds of hypercholesteremia [OR (95% CI) = 10.71 (2.64–43.41), p < 0.001] in non-diabetic controls and poor sleep quality was associated with increased odds of low HDL cholesterol in T2DM patients [3.2 (1.38–7.48), p = 0.007] and hypertriglyceridemia in non-diabetic controls [2.54 (1.15–8.51), p < 0.001]. Conclusion: In our study population, depression and poor sleep quality were common in T2DM patients compared to non-diabetic controls. Depression and poor sleep quality were associated with abnormalities in serum lipid levels, but not glycemic control.