Symptoms of Depression as a Risk Factor for Incident Diabetes: Findings from the National Health and Nutrition Examination Epidemiologic Follow-up Study, 1971-1992

Carnethon, Mercedes R.; Kinder, Leslie S.; Fair, Joan M.; Stafford, Randall S.; Fortmann, Stephen P.

doi:10.1093/aje/kwg172

Cited by 211 publications

(173 citation statements)

References 32 publications

(29 reference statements)

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“…However, there was no significant elevation in fasting glucose, post prandial glucose, cholesterol and prevalence of MS in the bipolar group. This corroborated in part to the authors' hypothesis that the patient of BPD would have a significantly higher level of IR and were consistent with previous studies [23,24].…”

Section: Discussionsupporting

confidence: 93%

Assessment of Insulin Resistance and Metabolic Syndrome in Drug Naive Patients of Bipolar Disorder

et al. 2013

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The levels of fasting glucose, fasting insulin, insulin resistance (IR) and the prevalence of metabolic syndrome (MS) in a sample population of bipolar disorder (BPD) patients who were newly diagnosed and psychotropically naïve were assessed and compared with an age, sex and racially matched control population. 55 BPD-I patients (15-65 years) who were non-diabetic, nonpregnant, and drug naïve for a period of at least 6 months were included in the study. Diagnosis was made using the structured clinical interview for DSM-IV axis I disorders (SCID IV). IR was assessed using homeostasis model of insulin resistance (HOMA-IR); MS was defined according to National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III). Data were compared with 25 healthy controls. BPD patients had significantly higher mean levels of fasting plasma insulin (13.2 ± 9.2 vs. 4.68 ± 3.1 lIU/ ml, p \ 0.05), postprandial plasma insulin (27.2 ± 14.5 vs. 18.1 ± 9.3 lIU/ml, p \ 0.05) and a higher value of HOMA-IR (3.16 ± 2.2 vs. 1.19 ± 0.8, p \ 0.05) when compared to the controls. A significantly higher proportion of patients of BPD compared to controls were manifesting levels of fasting plasma glucose, serum triglyceride and blood pressure higher than the cut off while waist circumference and serum HDL cholesterol failed to show any significant difference in the proportion. There was a significantly higher proportion of prevalence of IR between BPD cases and controls (26/55 vs. 2/25, z value 9.97, p \ 0.05) while there was no significant difference in proportion of prevalence of MS between these two groups. Within BPD patients, logistic regression analysis showed that age, sex or current mood status (depressed/ manic) were not significantly predictive of presence or absence of MS or increased IR.

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Section: Discussionsupporting

confidence: 93%

Assessment of Insulin Resistance and Metabolic Syndrome in Drug Naive Patients of Bipolar Disorder

et al. 2013

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“…First, adjustment for age, sex and especially the Chronic Disease Score will already have captured some of the effects that other confounders might have had and therefore additional adjustment for other confounders probably would not have had a very large effect. Second, previous studies that investigated the association between depression and diabetes, and adjusted for many confounders showed a maximal change of their age-and sex-adjusted effect estimate of 26% [2,19]. The effect that we showed was quite large, especially in the month after initiation of diabetes treatment, and a reduction of 26% would still leave a considerable effect size.…”

Section: Discussionmentioning

confidence: 41%

Antidepressant use before and after initiation of diabetes mellitus treatment

et al. 2009

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Aims/hypothesis Although current literature suggests an association between diabetes and depression, the direction of the association is unclear. We examined the temporal association between diabetes and depression by studying antidepressant and benzodiazepine use around the initiation of diabetes treatment. Methods From a pharmacy registry database we selected 49,593 diabetic patients and a random sample of non-diabetic individuals (n=154,441), all >40 years old. Antidepressant and benzodiazepine use was calculated for the 7 years before and 7 years after the index date. The index date in diabetes patients was defined as the date of initiation of diabetes medication. A random index date was assigned to nondiabetic individuals. Time-specific incidence rate ratios of antidepressant and benzodiazepine use were calculated for intervals of 1 year, 3 months and 1 month. Results Antidepressant and benzodiazepine use was increased 2 months before and 3 months after the initiation of diabetes treatment compared with non-diabetic individuals.The strongest increase in incidence of antidepressant and benzodiazepine use was seen in the month after initiation of diabetes treatment with incidence rate ratios of 2.4 (95% CI 2.0-3.0) and 3.4 (95% CI 3.0-3.8) respectively, after adjustment for age, sex and Chronic Disease Score. Conclusions/interpretation The increased incidence of antidepressant and benzodiazepine use may be a consequence of the burden of disease, of starting with diabetes medication or of being diagnosed with diabetes. Our findings could also reflect earlier detection by their physician.

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“…After careful selection, 11 studies appeared to have studied the relation between depression and onset of type 2 diabetes longitudinally [10][11][12][13][14][15][16][17][18][19][20]. Searching the online PsycInfo database yielded no additional studies.…”

Section: Search Resultsmentioning

confidence: 99%

“…One of the 11 studies was excluded [17] because there was insufficient information in the article to calculate a relative risk. Two studies used data from the same cohort [12,20], the National Health and Nutrition Examination Survey (NHANES), and the most recent publication was included [12]. All studies excluded prevalent diabetes at baseline.…”

Section: Search Resultsmentioning

confidence: 99%

“…The pooled relative risk (95% CI) of studies that did control for undetected diabetes by screening all subjects for high blood glucose [14,15,19] was slightly higher, namely 1.54 (1.07-2.22). The four studies [10][11][12][13] that determined type 2 diabetes at follow-up by means of self-report had a pooled relative risk (95% CI) of 1.32 (0.98-1.78) ( Table 2). The studies that assessed diabetes onset by measuring glucose levels [14-16, 18, 19] instead of self-report, had a pooled relative risk (95% CI) of 1.43 (1.12-1.81).…”

Section: Subgroup and Sensitivity Analysesmentioning

confidence: 99%

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Depression as a risk factor for the onset of type 2 diabetes mellitus. A meta-analysis

et al. 2006

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Aims/hypothesis: Evidence strongly suggests that depression and type 2 diabetes are associated, but the direction of the association is still unclear. Depression may occur as a consequence of having diabetes, but may also be a risk factor for the onset of type 2 diabetes. This study examined the latter association by reviewing the literature and conducting a meta-analysis of longitudinal studies on this topic. Methods: Medline and PsycInfo were searched for articles published up to January 2005. All studies that examined the relationship between depression and the onset of type 2 diabetes were included. Pooled relative risks were calculated using fixed and random effects models. To explore sources of heterogeneity between studies, subgroup analyses and meta-regression analyses were performed. Results: Nine studies met our inclusion criteria for this meta-analysis. The pooled relative risk was 1.26 (1.13-1.39) using the fixed effects model and 1.37(1.14-1.63) using the random effects model. Heterogeneity between studies could not be explained by (1) whether studies controlled for undetected diabetes at baseline; (2) the method of diabetes assessment at followup; (3) the baseline overall risk of diabetes in the study population; and (4) follow-up duration. Conclusions/ interpretation: Depressed adults have a 37% increased risk of developing type 2 diabetes mellitus. The pathophysiological mechanisms underlying this relationship are still unclear and warrant further research. A randomised controlled study is needed to test whether effective prevention or treatment of depression can reduce the incidence of type 2 diabetes and its health consequences.

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Symptoms of Depression as a Risk Factor for Incident Diabetes: Findings from the National Health and Nutrition Examination Epidemiologic Follow-up Study, 1971-1992

Cited by 211 publications

References 32 publications

Assessment of Insulin Resistance and Metabolic Syndrome in Drug Naive Patients of Bipolar Disorder

Assessment of Insulin Resistance and Metabolic Syndrome in Drug Naive Patients of Bipolar Disorder

Antidepressant use before and after initiation of diabetes mellitus treatment

Depression as a risk factor for the onset of type 2 diabetes mellitus. A meta-analysis

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