Association between social supports and depression among patients with diabetes mellitus in Ethiopia: a systematic review and meta-analysis

OBJECTIVE: The adverse effects of poor social support on quality of life and adherence to treatment are established. However, the relationship between social support and depression is not well understood. In this systematic review and meta-analysis, we aim to examine the association between social support and depressive symptoms among type 2 patients with diabetes. DESIGN: Systematic review and meta-analysis. DATA SOURCES: We searched PubMed, African Journals Online, Web of Science, and the Cochrane Library electronic databases. Some studies were also identified through manual Google search and Google scholar. ELIGIBILITY CRITERIA: We systematically searched electronic databases for studies published up to October 2020. Only English-language articles were included. DATA EXTRACTION AND SYNTHESIS: Screening, data extraction and quality appraisal were conducted by two independent reviewers. A random-effect model was applied to estimate ORs with 95% CIs. The Higgins I(2) test was used to assess the heterogeneity between the studies. The risk of publication bias was estimated using the Egger test. Leave-one-out analysis was done. Data were analysed using Stata V.11. RESULTS: Seven studies were included in the meta-analysis. The findings from included studies revealed that poor social support increases the odds of depression among patients with diabetes (adjusted OR=2.14, 95% CI 1.34 to 3.43, p=0.003). There was no risk of publication bias (p=0.064), and heterogeneity was substantial (I(2)=70.7%). The leave-one-out analysis confirmed the consistency of the findings. CONCLUSIONS: Our meta-analysis revealed that patients who had poor social support were significantly associated with an increased level of depression. Additional studies exploring factors that might moderate or mediate this association are needed. Targeted interventions for comorbid depression should be implemented in clinical practice. SYSTEMATIC REVIEW REGISTRATION: We have submitted the protocol for registration at the PROSPERO on 9 October 2020. But we have not yet received a registration number.