ORIGINAL ARTICLE Relation between mental health-related variables and glycemic control in Malaysian women with type 2 diabetes mellitus (T2DM) Syed Shahzad Hasan & Kaeshaelya Thiruchelvam & Syed Imran Ahmed & Alexandra M. Clavarino & Abdullah A. Mamun & Therese Kairuz Received: 31 August 2013 /Accepted: 12 November 2014 /Published online: 30 December 2014 # Research Society for Study of Diabetes in India 2014 Abstract The primary objective of this study was to examine the association between depression, anxiety symptoms, and glycemic control in Malaysian women with type 2 diabetes mellitus (T2DM). Another objective was to examine the as- sociation between glycemic control and mental status, mea- sured by mental composite score (MCS). This study was conducted on 611 randomly sampled Malaysian women with T2DM who were treated as outpatients at medication therapy adherence clinics (MTAC). The Delusions-Symptoms-States Inventory: State of Anxiety and Depression (DSSI/SAD) and Center for Epidemiologic Studies Depression Scale 10 (CES- D 10) were used. Five most recent readings of hemoglobin A1c (HbA1c), fasting, and random glucose levels were re- corded. Regression analysis was used to correlate glycemic control with depression, anxiety symptoms, and MCS, while considering potential confounders. For depression symptoms, an increase of one category was associated with a small average HbA1c increase of 0.10 % (95 % CI -0.38, 0.68), whereas for anxiety symptoms, there was a small decrease in average HbA1c of 0.44 % (95 % CI -1.17, 0.28); both were not significant. Very poorly controlled HbA1c was not signif- icantly associated with symptoms of depression (OR 1.43, 95 % CI 0.45–4.55) or anxiety (OR 0.47, 95 % CI 0.15– 1.49). MCS was found to have a strong inverse correlation with HbA1c. That is, women who reported poor MCS had a significantly higher, and therefore very poorly controlled, HbA1c (OR 1.70, 95 % CI 1.01–2.88). The presence of depression and anxiety symptoms was not significantly asso- ciated with glycemic control in women with T2DM, supporting the hypothesis that argues against the existence of a link between depression, anxiety, and glycemic control. Keywords Mental health . Depression . Anxiety . Type 2 diabetes mellitus . Women . Malaysian Introduction People with diabetes mellitus (DM) experience a number of complications during the course of the disease, including psychological problems. Depression and anxiety are the two most common comorbid conditions associated with DM [1]. Comorbid depression or anxiety together with DM may result in poor metabolic control, higher complication rates, poorer quality of life (QoL), increased management costs, disability, and mortality rates [2–4]. It has been estimated that depressive disorders are higher among women with or without diabetes than among men; globally, depressive disorders in women were the fourth leading cause of disease burden and the seventh leading cause in men [2–4]. Studies from developed countries reported higher prevalence of depression in women compared to men [3, 5]. Although not many studies have been S. S. Hasan (*) : A. M. Clavarino : T. Kairuz The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD 4102, Australia e-mail: shahzad.syed@uqconnect.edu.au A. M. Clavarino e-mail: a.clavarino@sph.uq.edu.au T. Kairuz e-mail: t.kairuz@pharmacy.uq.edu.au K. Thiruchelvam : S. I. Ahmed International Medical University, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia K. Thiruchelvam e-mail: kaeshaelya@hotmail.com S. I. Ahmed e-mail: imran_ahmed@imu.edu.my A. A. Mamun The University of Queensland, Herston Road, Herston, QLD 4006, Australia e-mail: mamun@sph.uq.edu.au Int J Diabetes Dev Ctries (July–September 2015) 35(3):211–218 DOI 10.1007/s13410-014-0250-7