INS and depressive symptom measurement: A study of the 2006 Preventive Behavioral Risk Factor Surveillance System (PBRFSS) (a cross-sectional, random-sample, telephone survey) reported depression prevalence of 24 % in people with T2DM using insulin, and 17.3 % in people with T2DM not using insulin (depression was defined as total score ≥10 on the Patient Health Questionnaire, PHQ-8, administered in 36 states and territories in 2006) [11].