Abstract

Patients with type 2 diabetes mellitus (T2DM) are more sensitive to the stressors of war, which is added to the traditionally common psychopathological disorders of T2DM. The question of the connection between a reduced level of vitamin D and the course of T2DM at the background of anxiety disorders and depression remains relevant.

Aim: to assess the relationship between the concentration of serum cortisol, magnesium and 25-hydroxycholecalciferol (25-OH D) with the severity of psychopathological disorders in patients with T2DM.

Materials and methods: a total of 121 patients diagnosed with T2DM, aged 19-75 years, were examined. Assessment of vitamin D and cortisol in serum was carried out by CLIA chemiluminescent immunoassay. The severity of depression, anxiety and stress was assessed using the DASS21 questionnaire.

Results and discussion. The average level of glycated hemoglobin (HbA1c) of the examined patients was 8.6 %. There was no significant difference between male and female patients. From the three main psychological disorders: anxiety, stress and depression, anxiety had the greatest effect on cortisol levels. During depression and stress, serum cortisol levels were observed, which were below the lower reference level in a small number of patients (0.1%). A significant decrease in 25-OH D was observed in proportion to the increase in the severity of anxiety, stress, and depression, which is consistent with the literature on the relationship of vitamin D with mood by affecting the corresponding areas of the brain and the study of its positive effect on cognitive functions and the course of diabetes.

Conclusions. Anxiety in patients with T2DM is accompanied by higher cortisol levels than depression and stress. Statistically significantly lower levels of 25-OH D were noted in patients with more severe degrees of psychopathological disorders. Vitamin D has a perspective for correcting not only metabolic disorders, but also psychopathological disorders in T2DM patients under conditions of chronic stress of war. In a status of high level of anxiety, there is a significant trend towards a decrease in magnesium in the blood of patients with diabetes mellitus compared to the absence of an anxious status.

Key words: anxiety, stress, depression, war, diabetes, 25-hydroxyvitamin D, 25-OH D, DASS21, cortisol

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