Biopsychosocial factors associated with a current depressive episode in diabetes: the ELSA‐Brasil study

Abstract

Aims Depression is more prevalent in people with diabetes, and is associated with worse diabetes outcomes. Depression in diabetes is more treatment resistant, and as underlying mechanisms are unknown, development of more effective treatment strategies is complicated. A biopsychosocial model may improve our understanding of the pathophysiology, and therewith help improving treatment options. Methods Diabetes was diagnosed according to American Diabetes Association (ADA) criteria and a current depressive episode according to the International Classification of Diseases (ICD‐10), based on the Clinical Interview Schedule Revised (CIS‐R). From the Brazilian Longitudinal Study of Adult Health (ELSA‐Brasil), we included 455 participants without diabetes with a current depressive episode and 10 900 without either diabetes or a current depressive episode. Furthermore, 2183 participants had diabetes alone and 106 had both diabetes and a current depressive episode. Variable selection was based on their relationship with depression and/or diabetes. Multinomial multivariate logistic regression was used to determine how the models differed between participants with and without diabetes. Results A current depressive episode in diabetes was related to being older and female, having poorer education, financial problems, experiencing discrimination at work, home and school, higher waist circumference, albumin to creatinine ratio and insulin resistance, and the presence of hypertension and cardiovascular disease. In non‐diabetes, a current depressive disorder was related to being female, not being black, low income, psychological and social factors, non‐current alcohol use, lower HDL cholesterol, higher insulin resistance and the presence of cardiovascular disease. Conclusions A current depressive episode in the presence compared with the absence of diabetes was related more to biological than to psychosocial factors.

Sense of Coherence, Locus of Control and Depression Symptoms in Adolescents with Type 1 Diabetes

“…Indeed, the level of depression symptoms in young diabetics in our study can be classified as mild depression. Many sources report that the prevalence of depression among diabetics type 1 and type 2 is higher compared to the people without diabetes (Gendelman et al, 2009;van Duinkerken et al, 2020). At the same time, we found that adolescents without diabetes show significantly higher levels of depressive symptoms.…”

Comment on van Duinkerken et al. Biopsychosocial factors associated with a current depressive episode in diabetes: The ELSA‐Brasil study

“…We read with great interest the findings of a cross-sectional analysis of ELSA-Brasil data by Van Duinkerken et al 1 The results of this study confirm that there are numerous biological, psychological and social correlates of depressive episodes in people living with diabetes. The authors concluded that a current depressive episode in the presence of diabetes was related more to biological than to psychosocial factors, compared with the absence of diabetes.…”

Satisfactory Control for Glucose Profile by Combined Agents of Xultophy with A Small Dose

“…In comparison with Humalog mix 25, Xultophy can bring better glucose variability with only one injection. The second is psycho-perspective [23]. The case feels easy because of a less anxious episode for hypoglycemia.…”