Tuesday, June 17, 2008
TUESDAY, June 17 (HealthDay News) -- The relationship between diabetes and
depression apparently cuts both ways: Not only are people with treated type 2
diabetes at a heightened risk for developing depression, individuals with
depression are also at risk for developing diabetes.
The research revelation suggests that both doctors and patients need to be
more aware of the dual risks.
"Doctors should have their sensitivity increased toward picking up on
the potential for more of their diabetes patients and more of their depression
patients having susceptibility to the other disorder," said Dr. Stuart
Weiss, assistant clinical professor of medicine at New York University School of
Type 2 diabetes and clinical depression tend to go hand in hand, the study
authors said, although the question has been, which comes first?
"There have been studies that show people with diabetes are twice as
likely to have symptoms of depression as those who don't, and it could either be
because depression itself leads to the development of type 2 diabetes or it
could be that having diabetes leads to the development of depression," said
study lead author Dr. Sherita Hill Golden, an associate professor of medicine
and epidemiology at Johns Hopkins University School of Medicine.
"There are several studies showing that depression and depressive
symptoms lead to the development of type 2 diabetes, but only a couple of
studies showing that diabetes itself leads to depression. We wanted to look to
see whether or not we could tease out the chicken-and-egg situation," she
Previous studies have also found that treating depression can help extend the
lives of people with diabetes.
The authors of the new study performed two analyses, both using information
from participants in the Multi-Ethnic Study of Arteriosclerosis trial.
The first analysis involved 5,201 individuals without type 2 diabetes at the
start of the trail and found that treated type 2 diabetes was associated with a
54 percent increased risk of developing depressive symptoms over 3.2 years.
Persons with untreated diabetes were not at risk of developing depression.
Interestingly, people with pre-diabetes or untreated diabetes were about 25
percent less likely to develop depressive symptoms than people with normal
fasting blood sugar levels, the researchers said.
"That was a little bit of a surprise," Golden said. The study
authors aren't sure why this was so, but suggest that maybe the monitoring
associated with treating diabetes might contribute to depression.
The second analysis included 4,847 participants and found that elevated
depressive symptoms were associated with a 42 percent greater likelihood of
developing diabetes during the follow-up period. The stronger the depressive
symptoms, the higher the chance of developing diabetes. After adjusting for such
factors as being overweight, not exercising and smoking, the risk of developing
diabetes was still 34 percent higher in patients with depression.
"Those with depression are more likely to consume more calories, be less
physically active and are more likely to smoke, so they just have poor overall
health behaviors in general," Golden said. "That seems to be one
component of treating depression that needs to be addressed."
The findings, published in the June 18 issue of the Journal of the
American Medical Association, indicate that integration of care may be
helpful to these patients, Golden said.
"For people who are being treated for symptoms of depression, it's
important also to think about some treatment modalities that can also help them
adopt healthy behaviors," she said. "And certainly among people who
have treated diabetes and who are at risk of developing depression, we need to
be aware of that increased risk."
Golden serves on the Merck & Co.'s clinical diabetes advisory board; the
study was supported by the U.S. National Institutes of Health.