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Severe complications of diabetes higher in depressed patients

Feb 2, 2010

This press release is an announcement submitted by Diabetes Care, and was not written by Diabetes Health.

Such complications include kidney failure, blindness, heart attack and stroke

Depression raises risks of advanced and severe complications from diabetes, according to a prospective study of Group Health primary-care patients in western Washington. These complications include kidney failure or blindness, the result of small vessel damage, as well as major vessel problems leading to heart attack or stroke.

The findings were published in Diabetes Care, a scientific journal of the American Diabetes Association. The study was conducted by scientists from the Group Health Research Institute, Seattle; the University of Washington (UW) School of Medicine and School of Public Health, and the Veterans Affairs Puget Sound Health Care System. The lead author is Dr. Elizabeth Lin of the Group Health Research Institute.

Among their research volunteers with type 2 diabetes followed over 5 years, major depression was associated with a 36 percent higher risk of developing advanced micro-vascular complications, such as end-stage kidney disease or blindness, and a 25 percent higher risk of developing advanced macrovascular complications, such as stroke or myocardial infarction (heart attack from a blood clot), compared with diabetes patients without depression. The clinically significant risks remained even after the researchers adjusted for diabetes severity and self-care activities.

Between 2000 and 2002, the Pathways Epidemiological Follow-up Study enrolled 4,632 primary-care Group Health Cooperative patients with diabetes. These patients were tracked through 2005-2007. The final sample size was 3,723. The researchers reviewed medical records, diagnostic and procedural codes, lists of prescribed medications, and death certificates to determine what happened to each patient over nearly five years. The researchers used proportional hazard models to calculate the association between depression and the risk of advanced complications. Even among patients with diabetes who had no prior indication of microvascular or macrovascular problems, depression increased the chances that these problems would develop.

As in earlier reports, the diabetes patients with major depression tended to be slightly younger, heavier, have more co-existing medical conditions, and were more likely to be treated with insulin than were diabetes patients without depression. They also had higher levels of a substance in the blood formed when the sugar glucose attaches to hemoglobin, an oxygen-carrying protein. The major depression group had a higher proportion of women and smokers. However, after controlling for these differences between depressed and non-depressed patients with diabetes, the increased risk of complications associated with depression remained.

Several previous studies suggest the negative relationship between depression and diabetes cuts both ways. People with depression are prone to diabetes, and vice versa. Impairment from diabetes, such as blindness or kidney failure requiring long-term dialysis, interferes with a person's daily life and can be overwhelming. The person may become depressed or an existing depression may worsen.

As the incidence of type 2 diabetes soars, the clinical and public health significance of these findings increases, the authors noted. Further research is needed, the authors added, to clarify the underlying biological mechanism for the association between depression and complications of diabetes, and to test interventions which might be effective in lowering the risk of complications among patients who have both diabetes and depression.

• • •

In addition to Lin, the researchers on the study were Dr. Carolyn M. Rutter, Malia Oliver, Dr. Evette Ludman, Dr. David McCulloch and Dr. Michael Van Korff of the Group Health Research Institute in Seattle; Dr. Wayne Katon and Dr. Paul Ciechanowski, both of the UW Department of Psychiatry and Behavioral Sciences; Dr. Susan Heckbert of the Cardiovascular Research Unit, UW Department of Epidemiology; Dr. Bessie Young of the Epidemiologic Research Information Center at the Veterans Affairs Puget Sound Health Care System and the UW School of Medicine; and Dr. Lisa Williams of the Division of Dermatology, UW Department of Medicine.

Grants from the National Institutes of Health supported the research.

• • •

Source: http://www.eurekalert.org/pub_releases/2010-01/uow-sco012710.php


Categories: Complications & Care, Diabetes, Diabetes, Heart Care & Heart Disease, Insulin, Type 2 Issues



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Comments

Posted by JulieHS29 on 2 February 2010

Diabetes not only weighs heavily on your mind, but on your wallet as well. I have been suffering with diabetes for over 5 years now. One way I have been trying to save some money is through buying OTC diabetes testing supplies. I found myself saving almost 50% on my glucose meters and lancet strips through ehealthsource.com. They have over 400 value-branded products that are all FDA approved. You should check it out today!

Posted by Anonymous on 2 February 2010

Stress doesn't help any health issue. It's amazing how much it contributes to the ill effects of all diseases, diabetes included. For those with diabetes, try your best every day. Test, eat correctly, exercise, talk with friends, and of course, see your doctor to balance your life. Pay attention! It's worth the investment. Happy to say after 33 years being a type 1 diabetic and having celiac disease I have no complications. A supportive husband, children and friends definitely help me every day.

Posted by whimsy2 on 3 February 2010

Well, duh, I could have told them that without the need to spend gazillions of bucks.


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