Psychological and medical problems caused by distress of war in patients with type 2 diabetes

Nowadays, the population of Ukraine is under the influence of many stressful factors. Anxiety disorders and a general decline in the quality of life were present even before the start of a full-scale war, as a result of the Covid-19 pandemic. The full-scale war contributed to the continuation and intensification of chronic stress, deepening depression, and anxious expectations among various categories of the population of Ukraine, not only due to the immediate danger to life, changes of residence, insomnia, staying in shelters, but also due to the uncertainty of the future. The prevalence of depression, post-traumatic stress disorder (PTSD), and their complications among the population of Ukraine, both within the country and among those who have left it as refugees, reaches 30 %. PTSD often overlaps with an additional anxiety disorder, alcohol abuse, depression, and psychosomatic disorders. To reduce complications from PTSD, early diagnosis, optimally carried out at the primary care level, is recommended. All categories of the population that have experienced a traumatic situation, including both military and civilians, are subject to examination. Leptin and ghrelin were studied to assess hormonal changes during major depressive disorder. The levels of these hormones are related to the body’s energy homeostasis. Chronic stress reduces leptin levels in blood serum. In addition, it has also been shown that the administration of leptin to animals can cause an antidepressant effect, which is accompanied by an increased expression of brain-derived neurotrophic factor in the hippocampus. Depression and anxiety are common comorbid conditions in patients with type 2 diabetes mellitus. Taking into consideration the proven bidirectional relationship between depression and diabetes, it is necessary to address both conditions effectively. Objective — assessment of the severity of depression in patients with T2DM with respect to their vitamin D status under conditions of chronic stress. Materials and methods. 133 patients with T2DM aged 19 — 75 were examined. Vitamin D status was assessed using the chemiluminescent immunoassay (CLIA) method. Depression was assessed using the DASS 21 questionnaire. Results. A significant inverse relationship between the level of vitamin D and the severity of depression was found. Conclusions. During the war in Ukraine, an increase in psychopathological disorders among the population has been observed. There is an evidence base indicating the negative impact of depression on the course of diabetes. Given the steady rise in cases of type 2 diabetes and psychopathological disorders in the Ukrainian population, it is necessary to implement measures to correct both carbohydrate metabolism and the psychological condition of patients. Our study demonstrated a statistically significant inverse correlation between the level of depression and the concentration of 25-hydroxycalciferol in patients with type 2 diabetes who are exposed to chronic stress.