Relationship between depression, quality of life and foot ulcer healing rates in type 2 diabetic (T2D) patients

Type 2 diabetes (T2D) prevalence is increasing, not only in Australia, but also worldwide. Often referred to as the `lifestyle disease of the 21st century', the impact it has on individuals can be profound. A significant co-morbidity and the most common complication of T2D is foot ulcers. There is an established relationship between depression and T2D; however, no studies have investigated this relationship amongst a population with a diabetic foot ulcer (DFU). This study's aim was to investigate the relationship between different levels of depressive symptoms, Quality of Life (QoL), and healing time of people with T2D and a DFU. The relationship between different levels of T2D on healing time of foot ulcers and QoL was also explored. The study's <br>sample was drawn from a High Risk Foot Service (HRFS) at Northern Health, Victoria, Australia. All participants had T2D and a neuropathic foot ulcer. The sample participants; 59 males and 22 females, with a mean age of 62.6 years (SD = 12.2, range of 21 years to 85 years), were assessed for their level of depressive symptoms using the Center for Epidemiologic Studies Depression scale and their QoL using the World Health Organisation Quality of Life BREF scale. Significant relationships were found between different levels of depressive symptoms, healing time and QoL. Higher levels of depressive symptoms correlated with longer healing time. T2D levels had no significant relationship with healing time or QoL; however, T2D levels mediated the direct relationship between depressive symptoms and healing time. Healing time was found to be inversely related to all measures of QoL. The clinical significance of these results is relevant, in providing insight into the relationship that depressive symptoms and QoL have with the healing time of diabetic foot ulcers. These results also suggest that treatment approaches incorporating the treatment of depression and improving QoL.