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Bidirectional association established between patients with type 2 diabetes and depression
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New study findings suggest a modest association between baseline depressive symptoms and incident type 2 diabetes.
Researchers from Johns Hopkins University, Northwestern University and other large U.S. institutions conducted two analyses to study the bidirectional association between diabetes and elevated depressive symptoms.
Using the Center for Epidemiologic Studies Depression Scale, the researchers measured depressive symptoms in an ethnically diverse group of men and women aged 45 to 84 enrolled in the Multi-Ethnic Study of Atherosclerosis study. Participants were categorized as having normal fasting glucose, impaired fasting glucose, untreated type 2 diabetes or treated type 2 diabetes.
The first analysis included 5,201 participants who did not have diabetes at baseline. During 3.2 years, the incidence rate of diabetes was 22 per 1,000 person-years for individuals with elevated depressive symptoms and 16.6 per 1,000 person-years for individuals without depression. Further, the incidence rate was 1.1 times higher for each five-unit increment in the depression scale score.
In the second analysis, they assessed 4,847 participants with no depressive symptoms at baseline. During 3.1 years of follow-up, the incidence rate for depressive symptoms was 27.9 per 1,000 person-years for individuals with IFG and 31.2 per 1,000 person-years for individuals with untreated type 2 diabetes. The researchers reported a positive association with depressive symptoms and treated type 2 diabetes, with an incidence rate of 61.9 per 1,000 person-years (OR=1.54).
The association between depressive symptoms and diabetes persisted across ethnic groups and after adjustment for potential confounders. This modest link may perhaps be explained by lifestyle factors — a hypothesis that needs to be evaluated in future studies, according to the researchers. – by Katie Kalvaitis
JAMA. 2008;299:2751-2759.
The association of depression and diabetes has become more well-recognized as of late. While clearly dealing with a chronic illness such as diabetes must be quite depressing, the association of diabetes with various mental disorders is more than just coincidence and the underlying pathology is currently being intensively investigated.
– Derek LeRoith, MD, PhD
Endocrine Today Editorial Board member