INS and depressive symptom measurement: Several factors such as gender, being unmarried, low education level, higher number of comorbidities and complications, and the need for insulin treatment have been associated with higher incidence of depression during the course of diabetes mellitus.15 According to our findings, depression was more likely in females, in patients using fatalistic, helplessness and avoidance approaches, in patients with poor compliance with dietary recommendations, lower educational status and longer duration of diabetes mellitus as consistent with the literature.