Depression rates increasing among young adults with type 2 diabetes in US and UK
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The proportion of people with type 2 diabetes diagnosed with depression in the U.S. and U.K. increased from 2006 to 2017, particularly among those diagnosed with diabetes at a younger age, according to a study published in Diabetologia.
“About one-third of people have prevalent depression at the time of diagnosis of diabetes, and the trend of this prevalence has been significantly increasing in U.S. and U.K., similar across all age groups at diagnosis of type 2 diabetes,” Sanjoy Ketan Paul, MS, PhD, professor of clinical epidemiology and biostatistics at the University of Melbourne in Australia, told Healio. “Young people diagnosed with type 2 diabetes younger than 40 years have a significantly higher risk of developing depression by about 20% to 55% compared with those who developed type 2 diabetes at age 50 years or older, the risk being similar irrespective of cardiometabolic comorbidities at type 2 diabetes diagnosis.”
Paul and colleagues conducted a retrospective cohort study of adults diagnosed with type 2 diabetes from Jan. 1, 2006, to Sept. 30, 2017, who had data available in the Health Improvement Network database in the U.K. and the Centricity (GE Healthcare) electronic medical records database in the U.S. Adults were defined as having young-onset diabetes if they were younger than 40 years at baseline. Participants were considered to have depression if they were diagnosed or were prescribed any antidepressant medication at least two times within a 6-month window. Demographics and comorbidities were extracted from medical records.
There were 230,932 adults with type 2 diabetes in the U.K. (mean age, 58 years; 57% men) and 1,143,122 adults with type 2 diabetes in the U.S. (mean age, 60 years; 46% men) included in the study. In the U.K., the prevalence of depression among adults with type 2 diabetes increased from 29% in 2006 to 43% in 2017. Similarly, the proportion of those with depression and type 2 diabetes in the U.S. increased from 22% in 2006 to 29% in 2017.
Compared with adults aged 50 years and older at diabetes diagnosis, men aged 18 to 39 years in the U.K. had a 23% to 57% greater risk for developing depression, and women aged 18 to 39 years had a 20% to 55% increased risk for depression. In the U.S., men aged 18 to 39 years had a 5% to 17% increased risk for depression compared with those aged 60 years and older, and women aged 18 to 39 years had an 8% to 37% increased risk for depression compared with women aged 60 years and older (P for all < .01). The presence of comorbidities did not affect depression risk.
“There is a need for a proactive approach to screen for diabetes in people with depression and also have a dedicated engagement with newly diagnosed type 2 diabetes patients in terms of addressing their potential mental health risk,” Paul said. “Lifestyle modification along with early therapeutic intervention for depression, when appropriate, with a holistic approach to risk factor management is crucial at the primary care level to address the long-term risk similarly in young- and usual-onset diabetes. It is recommended that clinicians screen regularly for depression in people with incident type 2 diabetes, particularly among those who are younger than 50 years, irrespective of their cardiometabolic comorbidity status.”
Paul said further research is needed to investigate how multiple comorbidities after a diabetes diagnosis interact with depression risk and whether depression risk varies among different ethnic groups.
For more information:
Sanjoy Ketan Paul, MS, PhD, can be reached at sambhupaul@hotmail.com.
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