Depression and Diabetes — A Bad Combination

Steven Dubovsky, MD

Disclosures

Journal Watch. 2011;31(2) 

In This Article

Abstract and Introduction

Abstract

In the Nurses' Health Study, both conditions increased all-cause and cardiovascular mortality, and the combination was worse than either condition alone.

Introduction

Both depression and diabetes increase the risk for cardiovascular disease (CVD), and depression is more common in patients with diabetes than in the general population. For this report from the longitudinal Nurses' Health Study, investigators used repeated structured questionnaires to examine the impact of diabetes and depression on CVD-related and all-cause mortality during 6 years of follow-up in 78,282 women aged 54 to 79 at baseline.

Depression was defined as having a diagnosis of depression, taking antidepressants, and/or reporting severe depressive symptoms. Type 2 diabetes was identified by reports of typical symptoms plus an elevated blood glucose level, of two or more elevated glucose levels, or of treatment with hypoglycemic agents. Compared with women who had neither condition, those who had depression only, diabetes only, and both conditions had age-adjusted risks of 1.76, 1.71, and 3.11, respectively, for all-cause mortality and 1.81, 2.67, and 5.38 for CVD mortality. Correcting for other risk factors (including BMI, smoking, alcohol intake, physical activity, hypertension, hypercholesterolemia, heart disease, stroke, and cancer), participants with both depression and diabetes still had the highest risks for all-cause and CVD mortality (relative risks, 2.07 and 2.72, respectively).

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