ДВАНАДЦЯТИМІСЯЧНА КЛІНІЧНА ДИНАМІКА У СПОСТЕРЕЖУВАЛЬНІЙ КОГОРТІ ДОРОСЛИХ ІЗ ДЕПРЕСИВНИМИ РОЗЛАДАМИ ТА ДІАБЕТИЧНОЮ ПОЛІНЕЙРОПАТІЄЮ ПРИ ЦУКРОВОМУ ДІАБЕТІ 2 ТИПУ

Depressive disorders and diabetic polyneuropathy can exacerbate pain, impair disease self-management, and diminish quality of life in type 2 diabetes mellitus; longitudinal studies simultaneously assessing multiple clinical domains remain limited. Objective. To characterize the 12-month dynamics of clinical, psychometric, and metabolic parameters and to examine baseline differences contingent upon achieving the criterion for a favorable response in depressive symptoms. Materials and Methods. A prospective, single-center, observational cohort study was conducted in accordance with the STROBE guidelines. The longitudinal cohort comprised 101 adult patients aged 40 to 59 years with verified type 2 diabetes mellitus, clinically confirmed diabetic polyneuropathy, and clinically significant depressive disorder Assessments were performed at baseline, 3, 6, and 12 months while patients received routine interdisciplinary clinical care, without protocol standardization or a control group. Depression was assessed using the Beck Depression Inventory-II (BDI-II), anxiety via the Hamilton Anxiety Rating Scale (HAM-A), and neuropathic pain through a visual analog scale, complemented by measurements of glycated hemoglobin, fasting and postprandial glucose, treatment adherence, and quality of life using the SF-12 questionnaire. Repeated measures were analyzed using the Friedman test and Cochran’s Q test, with effect size evaluated by Kendall’s W coefficient; baseline differences between subgroups were analyzed using the Mann–Whitney U test and Pearson’s χ² test. A favorable response was defined as a reduction in the BDI-II score of at least 50% from baseline or a final score < 14 points. The study was conducted in accordance with the principles of the Declaration of Helsinki of the World Medical Association (2013 revision). Written informed consent was obtained from all participants prior to the initiation of study procedures. Data are presented in an aggregated format and contain no information permitting direct identification of the participants. This work was integrated into the research activities of Bukhara State Medical Institute and the Department of Psychiatry and Narcology of Tashkent State Medical University addressing the comorbidity of depressive disorders and complications of type 2 diabetes mellitus. Results. All 101 cohort participants completed the 12-month follow-up. The mean BDI-II score decreased from 20.96 ± 6.29 to 11.60 ± 6.25 (Kendall's W=0.926; p < 0.001), the HAM-A score declined from 22.66 ± 6.08 to 13.76 ± 5.23, and pain intensity diminished from 5.75 ± 1.60 to 3.62 ± 1.36. The SF-12 mental component summary score increased progressively from 35.60±9.47 to 44.70±5.90, whereas the physical component summary score initially declined at 3 months before recovering to 41.60±5.20 at 12 months. Glycated hemoglobin rose from 8.53±0.89% to 8.74±0.96% at 3 months, subsequently declining to 7.92±0.86% at 12 months; fasting and postprandial glucose levels remained slightly above baseline values throughout the observation period. The number of patients with low treatment adherence decreased from 59 (58.4%) to 26 (25.7%). The predefined criterion for a favorable response was met by 47 patients (46.5%) at 12 months; those who achieved this criterion had lower baseline scores for depression, anxiety, pain, and HbA1c, along with higher quality-of-life scores (p<0.001 for all comparisons). Conclusions. Over 12 months of routine interdisciplinary follow-up, adults with depressive disorders, type 2 diabetes mellitus, and diabetic polyneuropathy exhibited substantial changes in depressive and anxiety symptoms, neuropathic pain, treatment adherence, and quality of life, whereas metabolic dynamics were not unequivocally favorable and clinically significant depressive symptoms persisted in more than half of the participants. The observational design without a control group precludes establishing treatment efficacy or independent predictors; however, the findings support structured longitudinal follow-up incorporating psychiatric, neurological, metabolic, and behavioral assessments.