Int. J. Pharm. Investigation, 2021; 11(3) : 327-332 International Journal of Pharmaceutical Investigation, Vol 11, Issue 3, Jul-Sep, 2021 327 Original Article INTRODUCTION Diabetes mellitus is the most prevalent metabolic disease, 1 causing end-organ damage in almost all vital organ, including the brain. 2 As per reports from the International Diabetes Federation, 463 million adults had diabetes in 2019, which is estimated to reach 700 million by 2045. 3 Patients’ life expectancy has improved as medical amenities and treatment techniques have advanced. As a result, the complications of diabetes, as well as its treatment and psychological components, may have a negative impact on a variety of aspects of life, including quality of life (QoL). 4 Depression and type 2 diabetes mellitus (T2DM) are important worldwide public health issues, and both are expected to be among the top five primary causes of disease burden by 2030. 5 Emerging data supports an epidemiological link between depression and T2DM, although the reason is unknown 6 and assumed to be multifactorial. 7 Comorbidity is thought to be caused by a variety of characteristics of the disease, including psychological and psychosocial consequences. 8 Despite the significant incidence and impact of comorbid depression in T2DM patients, there is no evidence that T2DM treatment regimens reduce the risk of depression. 9 T2DM patients taking oral therapy had a greater prevalence of depression, according to a cross-sectional research, 10 whereas Joseph et al. found a substantial link between insulin usage and depression. 11 In T2DM patients, however, a cohort study found no link between depression and therapy type. Previous research have found inconsistencies in the relationship between depression and therapy type, necessitating further research. Diabetes is linked to decreased levels of cognitive function, according to an increasing amount of research, and may be a risk factor for mild cognitive impairment (MCI). Diabetes is linked to a 1.2-fold increase in the risk of cognitive impairment, according to research. 12 ere are few research evaluating the effect of diabetes treatment on cognitive performance, despite the fact that numerous studies have focused at the influence of diabetes on cognitive function. 13 Antidiabetics are thought to enhance cognitive function in diabetics by addressing vascular and neurodegenerative problems, as well as via direct pharmacological characteristics such as anti-inflammatory actions. 14 Clinical research, on the other hand, has shown conflicting outcomes. 15,16 e significant risk of MCI in diabetic individuals highlights the necessity to monitor the predictors of these diseases and develop treatment options. In the recent decade, the diabetes treatment emphasis has changed. Current diabetes treatment goals include not just metabolic management and the avoidance of acute and chronic consequences, but also the maintenance of a high quality of life. Diabetics have a poor quality of life, according to several clinical research. Diabetics have a poorer quality of life than healthy people, according to a case-control research. 17 Furthermore, numerous cross-sectional studies have shown that diabetics Association of Insulin Therapy with Depression, Cognition and Quality of Life in Type 2 Diabetes Patients: A Cross-sectional Study Rizwana Parveen 1 , Prem Kapur 2 , Nidhi Bharal Agarwal 3,* 1 Pharmaceutical Medicine, Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, INDIA. 2 Hamdard Institute of Medical Sciences and Research, HAH Centenary Hospital, Jamia Hamdard, New Delhi, INDIA. 3 Centre for Translational and Clinical Research, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi, INDIA. ABSTRACT Background: Type 2 diabetes mellitus (T2DM) is linked to a significant rate of depression and cognitive impairment, according to previous studies. However, limited research has been done on the effects of diabetes treatment on depression, cognitive function, or overall quality of life (QoL). This planned study investigated into depression, cognitive function, and quality of life in T2DM patients, as well as its relationship to treatment received. To study the association of insulin therapy with depression, cognition and quality of life in T2DM patients. Methods: This was a cross- sectional study that included 300 participants, comprising of 150 T2DM patients and 150 healthy individuals. The Patient health questionnaire and the Mini-mental state examination were used to measure depression and cognitive function, respectively. QoL was assessed using the Short-Form 36 (SF-36) questionnaire. Based on the type of treatment, all of the patients were divided into two subgroups: oral hypoglycemic medications (OHAs) and insulin. Results: The study included 300 participants, including T2DM patients (n=150) and healthy controls (n=150). In individuals with T2DM, the chances of mild (aOR 2.21, 95 % Ci 1.16-4.20; p=0.016) and severe (aOR 4.32, 95 % Ci 1.27-14.67; p=0.019) depression was higher. T2DM patients were also more likely to have cognitive impairment (aOR 2.86, 95 % Ci 1.16-6.99; p=0.021). Patients taking insulin had a substantially increased risk of depression (OR 2.127, 95 % Ci 1.070-4.228, p=0.036). Insulin-treated patients exhibited considerably poorer QoL ratings. Conclusion: The research illustrates that insulin therapy has a negative impact on depression and QoL in T2DM patients. As a result, it is recommended that insulin-treated T2DM patients require psychological assistance. In such cases, it is advised that measures to enhance QoL be implemented. Key words: Depression, Cognitive impairment, Quality of life, Hypoglycemic, Insulin, Type 2 diabetes. Correspondence Dr. Nidhi Bharal Agarwal, Centre for Translational and Clinical Research, School of Chemical and Life Sci- ences, Jamia Hamdard, New Delhi-110062, INDIA. Email id: nidhi.bharal@gmail.com DOI: 10.5530/ijpi.2021.3.58 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.