Severity of depression, anxious distress and the risk of type 2 diabetes – a population-based cohort study in Sweden

Abstract

Background Previous studies assessing the relationship between depression and diabetes mellitus did not consider the severity of depression. In the present study we assessed the risk of developing type 2 diabetes mellitus (T2DM) among people with various severity of depression. Methods This prospective longitudinal cohort study included 9,936 individuals residing in Stockholm County, Sweden who responded to the baseline questionnaire in 1998–2000. The participants were followed from 1 year after the baseline up to 2015 for the occurrence of T2DM, using the National Patient Register, Swedish Prescribed Drug Registers, and Cause of Death Register. Depression and anxious distress were assessed using psychiatric rating scales and defined according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Results Depression was associated with a statistically significant increased risk of T2DM after adjusting for potential confounders (OR 1.48, CI 1.10, 1.99). The strongest association was observed for severe depression (OR 1.72, CI 1.15, 2.59). Further, those with depression, regardless of severity, and with concurrent moderate/severe anxious distress had an increased risk of T2DM (OR 1.73, CI 1.13, 2.63) compared to those with neither depression nor anxious distress. Conclusions The study adds evidence that depression is associated with a higher risk for developing T2DM , and the association is stronger among people with severe depression. Electronic supplementary material The online version of this article (10.1186/s12889-019-7322-z) contains supplementary material, which is available to authorized users.

Depression was associated with younger age, female sex, obesity, smoking, and physical inactivity, in 1027 patients with newly diagnosed type 2 diabetes: a Swedish multicentre cross-sectional study

“…A bidirectional link between depression and type 2 diabetes (T2D) has been demonstrated, but depression seems to be a stronger risk factor for T2D than the other way round [ 2 , 3 ]. The presence of anxiety in depressed people seems to further increase the risk of developing T2D [ 4 ]. Depression is, however, a heterogenous disorder characterized by dysphoria, anhedonia and/or lack of interest, accompanied by cognitive symptoms, increased or decreased appetite, weight gain or weight loss, hypersomnia or insomnia, psychomotor retardation or activation, and fatigue, leading to functional deterioration [ 5 ].…”

Effect of omega‐3 and vitamin D co‐supplementation on psychological distress in reproductive‐aged women with pre‐diabetes and hypovitaminosis D: A randomized controlled trial

“…Moreover, irrespective of the severity of depression, severe and moderate anxiety both increased the risk of developing type-II diabetes (Deleskog et al, 2019).…”

“…Another study also conducted in Sweden showed that depression has a significant relationship with an increased risk of developing diabetes, and this relationship became stronger as the severity of depression increased. Moreover, irrespective of the severity of depression, severe and moderate anxiety both increased the risk of developing type‐II diabetes (Deleskog et al., 2019 ).…”

Probiotics, prebiotics, and synbiotics added to dairy products: Uses and applications to manage type 2 diabetes

“…T2DM is associated with gut dysbiosis, oxidative stress, and neurological and behavioral disorders (Kobyliak, Falalyeyeva, Mykhalchyshyn, Kyriienko & Komissarenko, 2018;Asmat, Aba & Ismail, 2016). People with T2DM have reported two times higher prevalence of depression, and in most cases it remains underdiagnosed (Bădescu et al, 2016;Deleskog et al, 2019;Sunny, Khanal, Sah & Ghimire, 2019). Likewise, there are reports that point differences between non-diabetic and diabetic gut microbiota; diabetics presented low bifidobacteria population and higher concentration of enterococci and Escherichia coli.…”