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Diabetes registry reveals relationship between depression, severe hypoglycemia
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Depressive symptom severity was positively associated with severe hypoglycemia in Japanese patients with type 2 diabetes, independent of glycemic control, insulin therapy, lifestyle factors and diabetic complications, according to recent study findings published in BMJ Open Research & Diabetes Care.
According to the researchers, clinicians should be aware of the association between depression and severe hypoglycemia since they are risk factors for morbidity and mortality in patients with diabetes.
Masanori Iwase, MD, PhD, of Kyushu University in Japan, and colleagues evaluated 4,218 Japanese patients with type 2 diabetes from the Fukuoka Diabetes Registry to determine the relationship between depressive symptoms and clinical characteristics. Participants were divided into four groups using the Center for Epidemiologic Studies Depression Scale (CES-D): score of nine or less, score of 10 to 15, score of 16 to 23 and score of 24 or more.
Information on diabetes duration, alcohol intake, smoking habits, sleep duration, physical activity and severe hypoglycemia during the past year were provided by participants through a questionnaire.
BMI, leisure-time physical activity, current smoking, sleep duration, sucrose intake, skipping breakfast, insulin use, severe hypoglycemia, dysesthesia of both feet, history of foot ulcer, photocoagulation, ischemic heart disease and stroke were all significantly associated with depressive symptom severity following multivariate adjustments.
Severe hypoglycemia prevalence increased according to CES-D score in patients treated with sulfonylureas or insulin (P for trend < .0001). Similarly, the OR for severe hypoglycemia also increased among this subgroup according to CES-D score following multivariate adjustment for age, sex, duration of diabetes, HbA1c, insulin treatment, self-monitoring of blood glucose, leisure-time physical activity, skipping breakfast, dysesthesia of both feet, ischemic heart disease and stroke (P for trend < .01).
“In conclusion, this cross-sectional study revealed that severe hypoglycemia was positively associated with the severity of depressive symptoms in Japanese patients with type 2 diabetes independent of glycemic control, insulin therapy, lifestyle factors and diabetic complications,” the researchers wrote. “Since severe hypoglycemia and depression are known risk factors for morbidity and mortality in patients with diabetes, clinicians should be aware of this combination in clinical settings.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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