Glycemic outcomes related to depression in adults with type 1 diabetes

Egbuonu, Ifeoma; Trief, Paula M.; Roe, Cheryl

doi:10.1177/1359105319877298

Cited by 9 publications

(7 citation statements)

References 25 publications

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“…Regarding the association between glycemic control and depressive symptoms in T1DM and T2DM, a significant relationship was found in both groups, which is in accordance to what has been reported in the literature (Egbuonu et al, 2019;Park et al, 2004;Picozzi & DeLuca, 2019;Santos et al, 2013). Nevertheless, in other studies, depressive symptoms and glycemic control did not show a clinically significant association (Braz et al, 2012;Fisher et al, 2007).…”

Section: Discussionsupporting

confidence: 89%

Depressive symptoms in Type 1 and Type 2 Diabetes Mellitus and its relationship with glycemic control

Massano-Cardoso

Daniel

Rodrigues

et al. 2020

Rev Port Inv Comp Soc

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Objective: The current study assessed depressive symptoms in Type 1 Diabetes Mellitus (T1DM) and Type 2 Diabetes Mellitus (T2DM) patients and explored whether these symptoms were associated with glycemic control. Methods: A cross-sectional design was used. Patients attending diabetes consultations participated in the study (N = 347). Participants completed the Beck Depression Inventory (BDI), and glycemic control was based on A1C criteria. Results: The mean score on the BDI, for either T1DM or T2DM, was not clinically significant and was not associated with diagnosis duration. The association between depression and glycemic control was significant in both DM types. T2DM participants presenting more depressive symptoms were those with greater glycemic control. T1DM and T2DM differences regarding depressive symptoms were in somatic symptoms. Conclusions: In T2DM depressive symptoms may be confounded with DM physical consequences. There is also the possibility that negative mood plays a mediating role in mobilizing survival strategies that promote glycemic control. Furthermore, the assessment of depressive symptomatology in patients with diabetes could benefit from the availability of a disease-specific measure.

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Section: Discussionsupporting

confidence: 89%

Depressive symptoms in Type 1 and Type 2 Diabetes Mellitus and its relationship with glycemic control

Massano-Cardoso

Daniel

Rodrigues

et al. 2020

Rev Port Inv Comp Soc

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“…Prevalence rates for depression were more than 3-fold higher in people affected by T1DM (12%, range 5.8–43.3% vs. 3.2%, range 2.7–11.4%) and up to 2-fold higher in those with T2DM (19.1%, range 6.5–33% vs. 10.7%, range 3.8–19.4%) vs. healthy controls; in all cases (T1DM, T2DM, and healthy controls), higher rates of depression were observed in women compared to men ( 14 ). Moreover, other studies focusing on the comorbidity between depression and T1DM reported an inconsistency in prevalence rates, although confirming the close relationship between depression and poor glycemic control and lack of self-care in diabetic patients ( 18 , 19 ). Fisher et al suggested that the cause of these discrepancies may lie in a methodological issue associated with a difficulty to distinguish between a depressive state and emotional distress linked to management of the chronic disease ( 20 ).…”

Section: Introductionmentioning

confidence: 60%

“…Specifically, no association was revealed with HbA 1 c levels. There are conflicting data in literature regarding the link between indicators of glycemic compensation and depression, with some studies that highlight a poorer compensation in depressed subjects ( 19 ) and others that do not ( 40 , 57 ). It is worthy of note that in comparison with other studies in which indicators of metabolic compensation and levels of depression were evaluated contextually ( 19 ), in the present study HbA 1 c levels related to the last control undertaken over the previous 3 months, whilst the reference time frame for assessment of depression using the BDI-IA scale was the previous 2 weeks.…”

Section: Discussionmentioning

confidence: 99%

“…There are conflicting data in literature regarding the link between indicators of glycemic compensation and depression, with some studies that highlight a poorer compensation in depressed subjects ( 19 ) and others that do not ( 40 , 57 ). It is worthy of note that in comparison with other studies in which indicators of metabolic compensation and levels of depression were evaluated contextually ( 19 ), in the present study HbA 1 c levels related to the last control undertaken over the previous 3 months, whilst the reference time frame for assessment of depression using the BDI-IA scale was the previous 2 weeks. The findings obtained in our study agree with those reported by Fisher et al who raised the issue of the methodological limitation of a non-contextual evaluation to justify the lack of association between depression and Hb1Ac levels ( 20 ).…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, depression manifested in subjects affected by diabetes tends to adhere to a recurrent or chronic course ( 18 ). The concomitant presence of mood disorders is correlated with a worse prognosis for diabetes ( 21 ), a less healthy lifestyle and a greater lack of diabetic self-care ( 22 , 23 ), lower treatment compliance ( 24 , 25 ), higher HbA 1 c (Glycated Hemoglobin A1c) ( 19 , 24 , 26 – 29 ), additional complications of diabetes ( 30 , 31 ), a worsening of quality of life ( 24 , 32 ) and higher mortality rates ( 31 – 33 ). In addition, the continual self-care required in the treatment of diabetes (blood sugar measurements, multiple doses of insulin, diet, exercise, etc.…”

Section: Introductionmentioning

confidence: 99%

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Depression in Diabetic Patients: What Is the Link With Eating Disorders? Results of a Study in a Representative Sample of Patients With Type 1 Diabetes

et al. 2022

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Background and PurposeComorbidity between diabetes and depression, and diabetes and eating disorders (ED) conveys significant diagnostic, clinical and therapeutic implications. The present study was conducted on a sample of adult outpatients affected by Type 1 Diabetes (T1DM) to assess lifetime prevalence of ED; current prevalence of depression and Disturbed Eating Behaviors (DEB) and their impact on glycemic control. We hypothesized that patients with depression would have higher rates of lifetime ED and current DEB. We hypothesized a significant and independent association between DEB and the prevalence of depression.Materials and MethodsThe study was carried out using a cross-sectional design in a sample of 172 diabetic patients with T1DM aged from 17 to 55 years. Lifetime prevalence of ED according to DSM-5 criteria was assessed by means of the Module H modified of the Structured Clinical Interview for DSM-IV Axis I Disorder (SCID-I). The following questionnaires were used: Beck Depression Inventory–IA version (BDI-IA) and Diabetes Eating Problems Survey—Revised (DEPS-R), to assess respectively the current presence of depression and DEB. Socio-demographic, clinical, and laboratory data were also collected.ResultsHigh rates of depression (35.5%) and DEB (19.2%) were observed in our sample of 172 adult outpatients with T1DM. Lifetime history of ED was present in 20.9% of the sample and was more frequently diagnosed in patients with current depression (34.4% vs. 13.9%, p = 0.002). Higher levels of DEB at DEPS-R significantly increased the odds of depression (adjOR: 1.09; 95% CI: 1.03–1.15; p = 0.003). The presence of DEB was associated with poor glycemic control. On the other hand, no association was found between depression and metabolic compensation.ConclusionAdult patients with T1DM and depression should be screened for ED and DEB. Treating DEB could positively impact both mood and glycemic control in this population. Further studies should be carried out on a larger patient population using a longitudinal design and an accurate method of evaluation to explore the complex relationship between diabetes, depression, ED, and DEB. Future research should investigate treatment strategies for DEB in T1DM patients and their impact on both psychopathological and metabolic outcomes.

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Assessment of the spectrum of depression and bipolarity in patients with type 1 diabetes

Cyranka

Matejko

et al. 2022

Diabetes Metabolism Res

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Aims:The aim of the study was to check the prevalence of unipolarity (depression), bipolarity, as well as the quality of sleep and temperament traits in patients with type 1 diabetes (T1DM) who are provided with optimal conditions of diabetes care and to identify possible risk factors connected with affective traits. Materials and Methods: Out of the 107 T1DM patients, 78 (54 females, 24 males) were included for the analysis (HbA1c [%] 7.11 � 1.0, BMI [kg/m 2 ] 25.3 � 5.6; Years of disease duration [N] 13.7 � 8.3). The patients filled in a set of questionnaires during their regular visit to the outpatient clinic. Three patients from the whole group were on intensive insulin therapy with Multiple Daily Injections (MDI) and Self-Monitoring of Blood Glucose (SMBG), all the rest were on various types of personal insulin pumps (years on insulin pump [N] 9.1 � 4.5). All the patients were on regular diabetologist care, with regular visits in a Centre for Advanced Technologies in Diabetes (at least every 6 months). Results:In QIDS-S (full explanation and abbreviation 26 patients (33.8%) were screened positive for depression, in PHQ (full explanation and ab 57.7% of the patients (45 patients) had symptoms of depression (age was negatively correlated with PHQ score [r = −0.26; p = 0.023]). In CES-D 16 (20%) of the patients assessed their present affect as depressed. None of the analysed clinical variables correlated with depression scores. In the Mood Disorder Questionnaire (MDQ), 16 patients reported having symptoms of bipolarity (20.5% vs. 79.5%). Hypomania Checklist (HCL) analysis indicated 10 patients with bipolar traits (>14) (14.9% vs. 85.1%).None of the analysed clinical variables correlated with HCL results. 11.5% of patients were indicated to be of morning type. Morningness was more often seen in younger patients (r = 0.39; p = 0.001). As many as 46.6% declared that they had poor sleep quality. The temperament traits analysis correlated with clinical parameters: Cyclothymic temperament trait was negatively correlated with age (r = −0.30; p = 0.007) and positively with HbA1c level (r = 0.30; p = 0.025).Hyperthymic temperament was positively correlated with (BMI r = 0.28; p = 0.016).

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Glycemic outcomes related to depression in adults with type 1 diabetes

Cited by 9 publications

References 25 publications

Depressive symptoms in Type 1 and Type 2 Diabetes Mellitus and its relationship with glycemic control

Depressive symptoms in Type 1 and Type 2 Diabetes Mellitus and its relationship with glycemic control

Depression in Diabetic Patients: What Is the Link With Eating Disorders? Results of a Study in a Representative Sample of Patients With Type 1 Diabetes

Assessment of the spectrum of depression and bipolarity in patients with type 1 diabetes

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