Improvement of Glycemic Control in Insulin-Dependent Diabetics with Depression by Concomitant Treatment with Antidepressants

Radojkovic, Jana; Šikanić, Nataša; Bukumirić, Zoran; Tadić, Marijana; Kostić, Nada; Babic, Rade

doi:10.12659/msm.899571

Cited by 14 publications

(12 citation statements)

References 64 publications

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“…En la muestra estudiada predominó la ausencia de trastorno tanto para ansiedad como para depresión. Sin embargo, diversos estudios han indicado una mayor prevalencia de síntomas de depresión y ansiedad en pacientes con DM tipo 2, evidenciando una relación de dichos trastornos con el control glucémico (23,24). Por su parte, Pokrajac, Kukić, Klobučar y Tkalčić en un estudio similar reportaron que el 76,3% de los pacientes no estaban ansiosos y el 73,8% de los pacientes no presentaban síntomas de depresión (25).…”

Section: Discussionunclassified

Ansiedad y depresión en pacientes hospitalizados con diabetes mellitus tipo 2

Monterroza

Noriega

2021

Investg. Enferm. Imagen Desarollo.

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Introducción: estudios han reportado altos niveles de incertidumbre, ansiedad, depresión y desesperanza en pacientes diabéticos, afectando el control glucémico y la adherencia al tratamiento, favoreciendo las complicaciones micro y macro vasculares. Especialmente en los episodios de hospitalización, donde se alteran los procesos familiares, sociales y laborales, afectando la recuperación y el desenlace de la enfermedad, reflejado en mayores días de estancia hospitalaria, y por tanto elevando los costos asociados a la hospitalización. Objetivo: asociar la ansiedad y depresión en pacientes diabéticos hospitalizados según variables clínicas y sociodemográficas. Método: estudio cuantitativo, descriptivo con componente analítico, de corte transversal. Mediante un muestreo no probabilístico por conveniencia se seleccionaron 82pacientes diabéticos tipo 2, ambos sexos, en un hospital de la ciudad de Montería, Colombia. Se aplicó un cuestionario de caracterización del paciente y la Escala Hospitalaria de Ansiedad y Depresión. El análisis de los datos se realizó a través de SPSS 25. Resultados: predominó el sexo femenino (60%), la procedencia rural (51%) y la baja escolaridad (72%). Se evidencia ausencia de trastorno para ansiedad (54%) y depresión (65%). Se observó mediante la prueba χ2 asociación entre ansiedad y depresión con las variables edad, pareja estable (p = 0,002; 0,013), años de estudio (p = 0; 0,010) complicaciones (p = 0,008; 0,006) y días de hospitalización (p = 0,005; 0,004). Conclusión: se evidenció bajos niveles de ansiedad y depresión en los pacientes diabéticos hospitalizados. Así mismo se identificó que existe asociación de ambos trastornos con la edad, años de estudio y los días de hospitalización.

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Section: Discussionunclassified

Ansiedad y depresión en pacientes hospitalizados con diabetes mellitus tipo 2

Monterroza

Noriega

2021

Investg. Enferm. Imagen Desarollo.

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“…One possible explanation might be indication bias; that is, without the sexual dysfunction complication, the dosage of serotonergic agents such as SSRIs may be increased or they may be replaced with another antidepressant agent. Another study indicated that when depressive symptoms improved in patients who had DM with comorbid depression, glycemic control also improved 24 Cross-sectional studies have also reported associations between improved glycemic control and ameliorated sexual dysfunction in men with DM. 25,26 DM itself may affect sexual function through multiple pathophysiological pathways and have vascular, neurological, and hormonal effects.…”

Section: Discussionmentioning

confidence: 99%

<p>Effect of Depression and Antidepressants on Sexual Dysfunction in Men with Diabetes: A National Population-Based Cohort Study</p>

Chung¹,

Huang²,

Lee³

et al. 2020

NDT

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This study explored and compared the effects of depression and antidepressants on sexual dysfunction in men with diabetes mellitus (DM). Patients and Methods: Patients older than 18 years who had been newly diagnosed with DM (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] code 250) between 1999 and 2010 were identified from Taiwan's National Health Insurance Research Database and were followed up until 2013. Patients with preexisting depression or sexual dysfunction were excluded. A total of 636,210 patients with DM were enrolled. These patients were divided into two groups: DM with comorbid depression and a matched cohort without depression. The groups were followed up until the end of 2010 for the first diagnosis of sexual dysfunction (ICD-9-CM codes 302.70, 302.71, 302.72, 302.74, 302.75, 302.76, 302.79, 607.84, and V417). A Cox proportional hazard model and a Cox regression model with time-dependent covariates were applied. Results: Patients with DM and depression had a higher risk of sexual dysfunction than those with DM without depression (hazard ratio [HR] = 1.44; 95% confidence interval [CI], 1.33-1.55). The risk of sexual dysfunction was lower in the subgroup who used antidepressants (per 28 cumulative defined daily doses [cDDDs]), HR = 0.96; 95% CI, 0.94-0.97). A significantly lower incidence of sexual dysfunction was also associated with the use of selective serotonin reuptake inhibitors (SSRIs, per 28 cDDD). The adjusted HR was 0.95 (95% CI, 0.93-0.97). Subgroup analysis indicated that SSRI use was significantly associated with an amelioration of erectile dysfunction (per 28 cDDD), with an HR of 0.95 (95% CI, 0.92-0.97). Conclusion: Male patients with DM and depression are at increased risk of sexual dysfunction. Antidepressant use had a small inverse association with the risk of sexual dysfunction in men with DM and depression. Antidepressants, in particular SSRIs, did not increase the risk of sexual dysfunction in this population.

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“…Спроби покращити контроль глікемії шляхом використання в комплексній терапії синтетичних антидепресантів дали неоднозначні результати: як позитивні для окремих препаратів [8,9], так і відсутність впливу на вуглеводний обмін [10]. Існують дані, що за ефективністю дії у хворих з легкою та помірною депресією рослинні препарати, що містять звіробій, компонент, що забезпечує доведений антидепресивний ефект, не поступаються синтетичним антидепресантам [11], але мають кращу, ніж у синтетичних сполук, переносимість [12].…”

Section: вступunclassified

Depressive disorders in patients with diabetes mellitus. The effect of sedariston phytopreparation on carbohydrate metabolism and psycho-emotional state of patients with anxiety-depressive syndrome

Tkach

Miliutina

2022

Mìžnarodnij endokrinologìčnij žurnal

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Background. Depressive disorders are quite common in patients with diabetes mellitus (DM). Depression is associated with worsening glycemic control. Attempts to improve it through the use of synthetic antidepressants in complex therapy have had mixed results. The study was aimed to evaluate the prevalence of depressive disorders in patients with diabetes mellitus treated in the endocrinology department and to evaluate the effect of combined herbal medicine Sedariston containing standardized extracts of Hypericum perforatum (100 mg) and Valeriana (50 mg) (Esparma GmbH, Germany) on carbohydrate metabolism and psycho-emotional state of diabetic patients with the anxiety-depressive syndrome. Materials and methods. The study included 122 patients with type 1 and 2 DM, 103 women and 19 men, aged 18 to 75 years. Thirty-three of them with anxiety-depressive syndrome participated in a 3-month study, 16 of which additionally received Sedariston 2 capsules twice a day for 2 months. Prior to, as well as 2 weeks, 1, 2, 3 months from the beginning of the observation, the psycho-emotional state was assessed with a determination of the severity of the depressive syndrome on the PHQ-9, Beck scales, as well as the state of personal and reactive anxiety on the Spielberger-Hanin’s scales. Glycated hemoglobin was determined before and 3 months after the start of monitoring. All patients received insulin therapy and/or hypoglycemic oral medications at constant doses during the observation. Results. Depressive disorders were identified in 80.3 and 67.2 %, respectively, according to the PHQ-9 and Beck scales. Most patients experienced mild and moderate depression. High personal anxiety was found in 66.4 %, high reactive anxiety in 50.8 % of patients. Patients in the Sedariston basic group reported significant improvement in depressive symptomatology with a decrease in PHQ-9 scores from 13.7 ± 1.6 to 9.3 ± 1.4 (p < 0.05) after 1 month of treatment, and on the Beck’s scale from 23.9 ± 1.8 to 18.2 ± 1.9 points (p < 0.05) after 2 months of treatment, in contrast to patients in the control group without Sedariston: 11.9 ± 1.2 and 10.8 ± 1.1 points (p > 0.1) on the PHQ-9 scale and 19.7 ± 1.7 and 18.9 ± 2.3 points (p > 0.1) on the Beck’s scale, respectively. The achieved improvement of the psycho-emotional state of patients after the end of treatment with Sedariston was maintained after 3 months from the beginning of monitoring: 7.1 ± 1.3 points on the PHQ-9 scale and 16.1 ± 2.1 points on the Beck’s scale (p < 0.01). After 2 months of Sedariston therapy in the group of patients with the anxiety-depressive syndrome, unlike the patients of the control group, personal anxiety decreased from 59.5 ± 2.2 to 53.5 ± 1.9 points on the Spielberger-Hanin’s scale (p < 0.05), in patients with high reactive anxiety, after 2 months of treatment significantly decreased its level from 57.4 ± 2.5 to 49.3 ± 2.7 points and remained so until the end of observation. Against the background of the positive dynamics of depressive symptoms in patients receiving Sedariston, a significant decrease in glycated hemoglobin occurred 3 months after the start of therapy: from 9.4 ± 0.5 to 8.1 ± 0.2 % (p < 0.05), unlike the patients of the control group. Conclusions. An anxiety-depressive syndrome is defined in 63.1 % of patients of the diabetology department, with depressive disorders mainly of mild and moderate severity, high personality and reactive anxiety, and 19.7 % of patients experienced a depressive syndrome without disturbance of anxiety, which indicates their diagnosis and conducting appropriate treatment. The combined phytopreparation Sedariston in the complex therapy of patients with diabetes mellitus, against the backdrop of the positive and long-lasting effect on anxiety-depressive symptoms, contributes to the improvement of carbohydrate metabolism, with a decrease of 1.3 % of glycated hemoglobin in 3 months. This indicates that Sedariston may be used not only for the treatment of anxiety-depressive syndrome but also to improve carbohydrate metabolism in patients with DM.

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Improvement of Glycemic Control in Insulin-Dependent Diabetics with Depression by Concomitant Treatment with Antidepressants

Cited by 14 publications

References 64 publications

Ansiedad y depresión en pacientes hospitalizados con diabetes mellitus tipo 2

Ansiedad y depresión en pacientes hospitalizados con diabetes mellitus tipo 2

<p>Effect of Depression and Antidepressants on Sexual Dysfunction in Men with Diabetes: A National Population-Based Cohort Study</p>

Depressive disorders in patients with diabetes mellitus. The effect of sedariston phytopreparation on carbohydrate metabolism and psycho-emotional state of patients with anxiety-depressive syndrome

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