Impact of Depression and Psychosocial Treatment on Heart Rate Variability in Patients with Type 2 Diabetes Mellitus: An Exploratory Analysis Based on the HEIDIS Trial

Zimmermann‐Schlegel, Verena; Wild, Beate; Nawroth, Peter P.; Kopf, Stefan; Herzog, Wolfgang; Hartmann, Mechthild

doi:10.1055/s-0043-125445

Cited by 8 publications

(7 citation statements)

References 47 publications

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“…The index ranges from 0.25 to 1.0, with indices below 0.5 being no depression; 0.5–0.59 being mild to mild depression, 0.60–0.69 being moderate to severe depression; and over 0.70 being severe depression. Zung tested the reliability and validity of the SDS: its internal consistency was satisfactory, with split correlations of 0.73 (1973) and 0.92 for the odd-even items (1986), with high and moderate correlations with scores on the Beck Depression Questionnaire, the Hamilton Depression Inventory, and the Matrix Metalloproteinase “d” subscale ( Zimmermann-Schlegel et al, 2019 ).…”

Section: Methodsmentioning

confidence: 99%

“…Studies have shown that depressive symptoms and glucose metabolism in middle-aged and elderly patients improve through general psychological support and other interventions ( Fiocco et al, 2013 ; Zimmermann-Schlegel et al, 2019 ). This study implemented psychological interventions for middle-aged and elderly patients in the following areas: first, behavioral therapy to intervene in diabetic diet and lifestyle changes so that patients can adapt to long-term treatment and strict dietary control as soon as possible; second, supportive therapy and coping guidance to improve the coping skills and social support system of middle-aged and elderly patients; third, relaxation therapy to relieve stress caused by tension-induced blood glucose fluctuations; fourth, cognitive therapy to reduce depression.…”

Section: Introductionmentioning

confidence: 99%

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Symptoms of depression, perceived social support, and medical coping modes among middle-aged and elderly patients with type 2 diabetes

Zhang

Lopez

et al. 2023

Front. Mol. Biosci.

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Objective: To understand the prevalence of depression in diabetes population, explore the relationship between diabetes and depression, and the impact of comprehensive psychological and behavioral intervention on depression related to diabetes and glucose metabolism.Methods: 71 middle-aged and elderly patients with type 2 diabetes were investigated and evaluated with Self Rating Depression Scale (SDS), Medical Coping Scale (MCWQ) and Social Support Scale (PSSS). Patients who met the research criteria were randomly divided into an experimental group and a control group. The number of effective cases in the two groups was 36 and 35 respectively. In addition to conventional diabetes drug treatment, the experimental group was supplemented with comprehensive psychological and behavioral intervention, while the control group was only given conventional treatment. The fasting blood glucose, 2-h postprandial blood glucose, body weight and depression index were measured before and after treatment in the two groups.Results: The prevalence of depression in patients with diabetes was as high as 60%, and that in the elderly control group was 5%; In type 2 diabetes population, depression is negatively related to the total score of social support and medical coping surface, and positively related to avoidance, blood sugar, women, course of disease, education level below junior high school, body mass index, and number of complications in medical coping; The fasting blood glucose, 2-h postprandial blood glucose, body mass index, and depression index of the two groups decreased, and the range and speed of decline in the experimental group were higher than those in the control group; There were significant differences between the two groups in fasting blood glucose, 2-h postprandial blood glucose and depression index; During the follow-up period, the blood glucose and depression index of the experimental group increased.Conclusion: Depression has a high prevalence rate in middle-aged and elderly people with type 2 diabetes, and has a negative impact on blood sugar control in diabetes patients; Psychological and behavioral comprehensive intervention can improve the glucose metabolism and depressive symptoms of middle-aged and elderly patients with type 2 diabetes.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Symptoms of depression, perceived social support, and medical coping modes among middle-aged and elderly patients with type 2 diabetes

Zhang

Lopez

et al. 2023

Front. Mol. Biosci.

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“…Although depression is an established risk factor for morbidity and early mortality, 16 little is known about the association between depression and HRV among people with diabetes. 17,18 An observational study has shown a mediating effect of depression in association between parasympathetic activation and HbA 1c among people with type 2 diabetes, 18 while another study in people with type 2 diabetes found no association between depression and HRV. 17 Studies in people with type 1 diabetes are still lacking.…”

Section: What's New?mentioning

confidence: 99%

“…17,18 An observational study has shown a mediating effect of depression in association between parasympathetic activation and HbA 1c among people with type 2 diabetes, 18 while another study in people with type 2 diabetes found no association between depression and HRV. 17 Studies in people with type 1 diabetes are still lacking.…”

Section: What's New?mentioning

confidence: 99%

“…As the prevalence of depression in people with diabetes is two to threefold higher than in people without diabetes, 16 these findings on depression and reduced HRV are particularly relevant to people with diabetes. Although depression is an established risk factor for morbidity and early mortality, 16 little is known about the association between depression and HRV among people with diabetes 17,18 . An observational study has shown a mediating effect of depression in association between parasympathetic activation and HbA 1c among people with type 2 diabetes, 18 while another study in people with type 2 diabetes found no association between depression and HRV 17 .…”

Section: Introductionmentioning

confidence: 99%

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Reduced heart rate variability in people with type 1 diabetes and elevated diabetes distress: Results from the longitudinal observational DIA‐LINK1 study

et al. 2023

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Aims People with type 1 diabetes have a higher risk for cardiovascular disease (CVD). Reduced heart rate variability (HRV) is a clinical marker for CVD. In this observational study using continuous HRV measurement across 26 days, we investigated whether psychological stressors (diabetes distress, depressive symptoms) and glycaemic parameters (hypo‐ and hyperglycaemic exposure, glycaemic variability and HbA1c) are associated with lower HRV in people with type 1 diabetes. Methods Data from the non‐interventional prospective DIA‐LINK1 study were analysed. At baseline, depressive symptoms and diabetes distress were assessed. Glucose values and HRV were recorded daily for 26 days using continuous glucose monitoring (CGM) and a wrist‐worn health tracker respectively. Multilevel modelling with participant as nesting factor was used to analyse associations between day‐to‐day HRV and diabetes distress, depressive symptoms and CGM‐derived parameters. Results Data from 149 participants were analysed (age: 38.3 ± 13.1 years, HbA1c: 8.6 ± 1.9%). Participants with elevated diabetes distress had a significantly lower HRV across the 26 days compared to participants without elevated distress (β = −0.28; p = 0.004). Elevated depressive symptoms were not significantly associated with HRV (β = −0.18; p = 0.074). Higher daily exposure to hyperglycaemia (β = −0.44; p = 0.044), higher average exposure to hypoglycaemia (β = −0.18; p = 0.042) and higher HbA1c (β = −0.20; p = 0.018) were associated with reduced HRV across the 26 days. Sensitivity analysis with HRV averaged across all days corroborated these results. Conclusions Diabetes distress is a clinically meaningful psychosocial stressor that could play a role in the cardiovascular health of people with type 1 diabetes. These findings highlight the need for integrated psychosocial care in diabetes management.

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Heart rate variability features from nonlinear cardiac dynamics in identification of diabetes using artificial neural network and support vector machine

Aggarwal

Das

Mazumder

et al. 2020

Biocybernetics and Biomedical Engineering

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Impact of Depression and Psychosocial Treatment on Heart Rate Variability in Patients with Type 2 Diabetes Mellitus: An Exploratory Analysis Based on the HEIDIS Trial

Cited by 8 publications

References 47 publications

Symptoms of depression, perceived social support, and medical coping modes among middle-aged and elderly patients with type 2 diabetes

Symptoms of depression, perceived social support, and medical coping modes among middle-aged and elderly patients with type 2 diabetes

Reduced heart rate variability in people with type 1 diabetes and elevated diabetes distress: Results from the longitudinal observational DIA‐LINK1 study

Heart rate variability features from nonlinear cardiac dynamics in identification of diabetes using artificial neural network and support vector machine

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