The increased prevalence of depression and anxiety in T2DM patients associated with blood glucose fluctuation and sleep quality

Abstract

Background Current evidence demonstrates that blood glucose fluctuation can be associated with depression and anxiety. The association among blood glucose fluctuation, traditional risk factors and emotional disorders in T2DM should be studied and clarified. Methods A total of 182 diabetic patients including 81 patients with depression or anxiety and 101 patients without emotional disorder were enrolled into this study. Data were obtained through medical history and questionnaire survey. Data were analyzed using appropriate statistical methods. Results The comparison results of basic information between the two groups showed that the differences of the proportion of female were statistically significant ( p = 0.002). There was no statistical difference in laboratory examination indexes between the two groups, however, standard deviation of blood glucose (SDBG) and postprandial glucose excursion (PPGE) of the comorbidity group were significantly higher than that of control group ( p = 0.032 and p = 0.037). The results of questionnaire survey showed that there were statistically significant differences in sleep quality, PSQI and dietary habit between the two groups ( p < 0.001, p < 0.001 and p < 0.001). Stratified analysis results according to gender showed that the percentage of cognitive disorder, anxiety and depression in female group was significantly higher than that in male group ( p = 0.001, p < 0.001 and p < 0.001). Mini-mental state examination (MMSE), self-rating anxiety scale (SAS) and patient health questionnaire (PHQ-9) score in female group were also higher than male group ( p = 0.001, p < 0.001 and p < 0.001). Logistic regression analysis results showed that SDBG and sleep quality were associated with emotional disorders in T2DM ( p = 0.040 and p < 0.001) and the OR values of these factors were 7.588 (1.097–52.069) and 4.428 (2.649–7.401). Conclusions Blood glucose fluctuation and sleep quality are associated with the increased prevalence of depression and anxiety disorders in T2DM.

Inflammation-activated C/EBPβ mediates high-fat diet-induced depression-like behaviors in mice

“…Besides neuroinflammation, HFD dysregulates glucose metabolism, causes chronic hyperglycemia and impairments of glucose tolerance, which eventually caused T2DM ( Dutheil et al, 2016 ). Indeed, T2DM is a major risk factor for depression and approximately 20–30% of diabetes patients suffer from depression ( Yang et al, 2022 ).…”

“…Clinical research demonstrated that blood glucose fluctuation and sleep quality are related to the increased prevalence of depression and anxiety disorders in patients with T2DM. Furthermore, the proportion of diabetes patients with depression is approximately 20–30% ( Yang et al, 2022 ). We previously confirmed that a high-fat diet (HFD) could induce T2DM through an inflammation-associated pathway ( Liu et al, 2022 ).…”

Alcohol Consumption Is a Coping Mechanism for Male Patients with Severe Anxiety Disorders Treated with Antidepressants Monotherapy

“…Alcohol consumption can lead to acute hypoglycemia by inhibiting gluconeogenesis [28], and chronic alcohol abuse can exacerbate insulin resistance, leading to persistent hyperglycemia and an increased risk of developing diabetes [29]. Although it may seem minor, fluctuations in blood sugar levels can worsen anxiety symptoms and contribute to mood instability [30], further complicating the management of anxiety disorders. Moreover, individuals with anxiety disorders may be more susceptible to the mood-altering effects of alcohol, leading to negative emotionality and impulsivity [31].…”

Incidence and Factors Associated with Hyperglycemia in Patients with First Hospitalization for Major Depression Disorder: A Large Cross-Sectional Sample

“…[31][32][33] In terms of psychopathological and psychological symptoms, the hyperglycemic group was also more severe, which is also consistent with previous findings. 24,34,35 In animal and clinical trials, it is found that hyperglycemia may affect patients' mood and behavior by affecting the hippocampus and amygdala, 36,37 the hypothalamus and its nucleus accumbens, 38 the HPA axis, 39 and MDD and hyperglycemic co-morbidity genes. 40 We also observed that waist circumference, other metabolic index levels and blood pressure were also higher in the hyperglycemic group than in the non-hyperglycemic subgroup, which is similar to the results of some previous studies, 21,34 suggesting that the overall metabolic level of patients with comorbid hyperglycemic MDD was disturbed, and interactions between different metabolic disorders have been found.…”