Depression in type 1 diabetes and risk of dementia

Gilsanz, Paola; Beeri, Michal Schnaider; Karter, Andrew J.; Quesenberry, Charles P.; Adams, Alyce S.; Whitmer, Rachel A.

doi:10.1080/13607863.2018.1455167

Cited by 19 publications

(16 citation statements)

References 49 publications

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“…While these rates appear concerning, they are similar to those reported in epidemiological studies and metaanalyses of the general type 1 diabetes population. [25][26][27] For example, these pre-transplant rates are highly comparable with those observed in a large cohort (n = 639) -24% had 'caseness' for anxiety and 21% for depressionprior to attending a UK structured type 1 diabetes education program. 28 Importantly, it has been noted elsewhere that questionnaire-based scores of generic anxiety/ depression show moderate-to-strong correlations with diabetes-related distress.…”

Section: Discussionsupporting

confidence: 64%

Characterization of pre-transplant psychosocial burden in an integrated national islet transplant program

Liew

Holmes‐Truscott

Flatt

et al. 2020

Islets

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The psychological burden experienced by people with diabetes prior to islet transplantation is recognized but has not been studied comprehensively, especially in relation to glycemia. Therefore, we conducted a rigorous pre-operative psychosocial profile of UK islet transplant recipients, and compared groups with higher/lower HbA1 c to test the null hypothesis that pre-transplant hypoglycemia awareness and psychosocial burden would not be related to baseline HbA1 c in this high-risk cohort. Pre-transplant, recipients (n = 44) completed validated hypoglycemia awareness questionnaires and generic/diabetes-specific measures of psychological traits and states. Scores were compared in groups, dichotomized by HbA1 c (≤8% versus >8%). Participants were aged (mean±SD) 53 ± 10 years; 64% were women; with HbA1 c 8.3 ± 1.7%. Median rate of severe hypoglycemia over the preceding 12 months was 13 events/person-year and 90% had impaired awareness of hypoglycemia (Gold/Clarke score ≥4). Participants had elevated fear of hypoglycemia (HFS-II Worry), impaired diabetes-specific quality of life (DQoL) and low generic health status (SF-36; EQ-5D). One quarter reported scores indicating likely anxiety/depression (HAD). Dispositional optimism (LOT-R) and generalized self-efficacy (GSE) were within published 'norms.' Despite negative perceptions of diabetes (including low personal control), participants were confident that islet transplantation would help (BIPQ). Hypoglycemia awareness and psychosocial profile were comparable in lower (n = 24) and higher (n = 20) HbA1 c groups. Islet transplant candidates report sub-optimal generic psychological states (anxiety/depressive symptoms), health status and diabetes-specific psychological states (fear of hypoglycemia, diabetes-specific quality of life). While their generic psychological traits (optimism, selfefficacy) are comparable with the general population, they are highly optimistic about forthcoming transplant. HbA1 c is not a proxy measure of psychosocial burden, which requires the use of validated questionnaires to systematically identify those who may benefit most from psychological assessment and support.

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Section: Discussionsupporting

confidence: 64%

Characterization of pre-transplant psychosocial burden in an integrated national islet transplant program

Liew

Holmes‐Truscott

Flatt

et al. 2020

Islets

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“…First, the cells were rinsed with cold PBS for 3 times, added with a lysis buffer containing 20 mM Tris-HCl solution (pH7.5, Solarbio company) and protein inhibitor (Solarbio company), and then carefully pipetted the solution so that the cells can be fully lyzed. Then, the solution was centrifuged at 1.6×10 4 xg for 15 min at 4°C , and 50 μL of the obtained supernatant was was processed for the determination of its protein concentration by BCA method. Next, 20 μg of protein and equivalent molecular weight standards were loaded into SDS-PAGE gel wells, and electrophoresed at 100 V for 2 h to isolate the protein.…”

Section: Western Blotmentioning

confidence: 99%

“…For example, Hainsworth et al 3 showed that T1D patients with hyperglycemia were highly likely to develop retinopathy. In addition, Gilsanz et al 4 exhibited that T1D patients with depression were often accompanied by a high risk of dementia. While according to Chaytor et al, 5 it was quite common for elderly patients with late T1D to suffer from cognitive impairment.…”

Section: Introductionmentioning

confidence: 99%

<p>Metformin Decreases Insulin Resistance in Type 1 Diabetes Through Regulating p53 and RAP2A in vitro and in vivo</p>

Ren

Xiao

et al. 2020

DDDT

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Purpose: Patients with type 1 diabetes (T1D) are associated with a high risk of multiple complications, so the development of T1D treatment is urgently needed. This study was set out to explore the molecular mechanism of metformin in the treatment of T1D insulin resistance.Patients and Methods: Subcutaneous adipose tissues were collected from 68 T1D patients and 51 healthy controls. Insulin resistance model rats and cells were constructed and treated with metformin respectively. Western blot was used to detect p53 and RAP2A protein levels, and qPCR was utilized to measure p53 and RAP2A mRNA levels. SiRNA and RAP2A siRNA vectors were constructed to observe their effects on insulin resistance model cells. Results: In T1D, p53 was up-regulated, while RAP2A was down-regulated. Metformin could effectively improve insulin resistance and inflammatory response while downregulating p53 and up-regulating RAP2A. P53 induced insulin resistance and inflammatory response by inhibiting RAP2A and promoted apoptosis. Conclusion: Metformin improves T1D insulin resistance and inflammatory response through p53/RAP2A pathway, and the regulation of p53/RAP2A pathway is conducive to improving the efficacy of metformin in the treatment of insulin resistance.

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“…Furthermore, multiple toxic factors might be synergistic in their negative effect on the brain environment. For example, having Type 1 diabetes and depressive symptoms might interact to impact the brain environment that over time leads to progressive cognitive impairment and a diagnosis of dementia (Gilsanz et al, 2018). The aging process also might serve as a toxic factor, in part, because the aging brain might be less resilient to brain stressors (McEwen & Morrison, 2013).…”

Section: Seed and Soil Model Of Neurocognitive Disordersmentioning

confidence: 99%

Biological markers of aging and mental health: A seed and soil model of neurocognitive disorders

McDonough

Allen

2018

Aging & Mental Health

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As the population of the world gets older, cognitive and mental health decline in older adults has become one of the most pressing scientific problems of the 21st century. It has been well-established that multiple pathways exist that can lead to future cognitive decline and the development of age-related mental health conditions. Making matters more complicated is the fact that aging is not a homogenous or simple process; rather, each person brings a diverse set of circumstances to the table, leading to differences in biologically aging. Research is needed to identify how the intersection of environmental and biological factors may protect older adults or put them at future risk for cognitive decline and the development of age-related mental health conditions. Furthermore, each potential factor may impact different domains of cognition and mental health or may impact individuals differentially based on genetic, environmental, social, emotional, and behavioral factors. Neuroimaging is one key tool that can be used to discover and assess markers of cognitive and mental health. The goal of this special issue is to expand the science on how biological markers can aid the understanding of aging and mental health through the lens of the individual from an international perspective, representing Germany, Taiwan, Thailand, the United Kingdom, and the United States. Common themes from these articles are used to support the new Seed and Soil Model of Neurocognitive Disorders.

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Depression in type 1 diabetes and risk of dementia

Abstract: For people with T1D, depression significantly increases dementia risk. Given the pervasiveness of depression in T1D, this has major implications for successful aging in this population recently living to old age.

Cited by 19 publications

References 49 publications

Characterization of pre-transplant psychosocial burden in an integrated national islet transplant program

Characterization of pre-transplant psychosocial burden in an integrated national islet transplant program

<p>Metformin Decreases Insulin Resistance in Type 1 Diabetes Through Regulating p53 and RAP2A in vitro and in vivo</p>

Biological markers of aging and mental health: A seed and soil model of neurocognitive disorders

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