Depression is two to three times higher in patients suffering from diabetes. Though identifying and managing depression is crucial in diabetes, it often goes undiagnosed. To understand the connection between Diabetes and Depression, Sanofi has curated the top 10 articles that will help add perspective to your practice. Read on to know more. 

2. Associations between depression and cognition, mild cognitive impairment and dementia in persons with diabetes mellitus a systematic review and meta-analysis ²

(Diabetes Research and Clinical Practice. 2022 Feb 2)

In persons with diabetes, depression is associated with worse cognition and higher dementia risk. The current systematic review and meta-analyses suggest that persons with DM and depression are more likely to suffer from worse overall cognition, deficits in language, memory and executive function and a 1.8 times higher risk of developing dementia than persons with DM only. Whether the risk of MCI is increased as well, remains unclear but seems likely given the associations with cognitive decline and dementia. The detrimental effects of depression on cognition may be mitigated by antidepressant treatment, but further research is required to confirm this.

3. Understanding the relationship between type 2 diabetes and depression lessons from genetically informative study designs. ³

(Diabetic Medicine. 2021 Feb)

Depression is often comorbid with type 2 diabetes. There is modest evidence to support the bi-directional phenotypic causation explanatory model of this phenomenon. Findings from genetically informed studies are mixed but provide some support for the uni- or bi-directional phenotypic model of depression and type 2 diabetes. Findings can inform multifaceted approaches to diabetes prevention and care that reflect how psychosocial factors contribute to type 2 diabetes risk and outcomes.

4. Pathophysiology linking depression and type 2 diabetes Psychotherapy, physical exercise, and fecal microbiome transplantation as damage control ⁴

(Eur J Neurosci. 2021)

Psychotherapy should be incorporated into the treatment regime of diabetes. Depression and diabetes share pathophysiological factors. Disruption in neurogenesis, neurotransmission, and metabolism. Neuroendocrine dysfunction, neuroinflammation, mitochondrial dysfunction, and redox imbalance are interlinked. Psychological stress, sleep deprivation, and gut dysbiosis aggravate the comorbid condition. Psychotherapy, physical exercise, fecal microbiome transplantation, and insulin-sensitization as damage control.

5. Changes in the Prevalence of Symptoms of Depression, Loneliness, and Insomnia in U.S. Older Adults with Type 2 Diabetes During the COVID-19 Pandemic The Look AHEAD Study ⁵

(Diabetes Care 2022)

The prevalence of mild or greater depressive symptoms in older adults with diabetes was more than 1.6 times higher during COVID-19 than before the pandemic. longitudinal study demonstrated that reports of mild or greater depressive symptoms, as well as loneliness, increased during the COVID-19 pandemic, yet over half of participants remained free of clinically significant levels of adverse mental health conditions. The prevalence of insomnia remained high but stable from before to during the pandemic. Participants at greatest risk of reporting symptoms of adverse mental health during COVID-19 were those who had reported such symptoms in the prior 3 years. Sex and race/ethnicity seemed to play an important role in these outcomes. Many older adults have demonstrated psychological resiliency amid the pandemic.

6. Increased rates of adverse perinatal outcomes in women with gestational diabetes and depression ⁶

(The Journal of Maternal-Fetal & Neonatal Medicine. 2021 Dec 2)

Women with GDM and a diagnosis of depression have higher rates of adverse perinatal outcomes than women with GDM alone. Identifying and managing depression among women with GDM has the potential to improve the care and health of this high-risk population. Results of the study demonstrate the necessity to identify women at high risk with earlier and more consistent screening for depression and depression prevention with counseling therapy as recommended by the US Preventative Services Task Force in 2019.

7. Depression, diabetes, their comorbidity and all-cause and causespecific mortality a prospective cohort study. ⁷

(medRxiv. 2022 Jan 1:2021-12)

This large prospective cohort study confirmed the negative impact of depression and diabetes on mortality outcomes. Comorbid depression and diabetes had synergistic effects on all-cause mortality which was largely driven by deaths due to cancer and causes other than circulatory disease and cancer. These findings help identify individuals at high risk of adverse events, and suggest a need for cost-effective interventions to support psychological wellbeing and risk reduction in people with diabetes.

8. Physical Activity and Psychological Stress Detection and Assessment of Their Effects on Glucose Concentration Predictions in Diabetes Management ⁸

(Nutrition Research. 2022 Apr 1)

The study shows increased intakes of multiple individual nutrients, fruit and vegetables were linked with a lower risk of noncommunicable diseases and may protect the public against its burden. Non-communicable disease (NCD) risks were significantly lower among individuals with higher intakes of multiple individual nutrients, fruits, and vegetables. Higher intakes of multiple individual nutrients were linked with a lower risk of NCDs in women. Higher intakes of fruits and vegetables were linked with a lower risk of NCDs in both women and men.

9. The mediating and interacting role of physical activity and sedentary behavior between diabetes and depression in people with obesity in United States ⁹

(Journal of Diabetes and its Complications. 2021 Jan 1)

Adults with obesity and diabetes are encouraged to increase moderate-intensity recreational activity and reduce SB, which can greatly prevent the occurrence of depression. Obesity is associated with an increased risk of depression in patients with diabetes. For people with obesity, moderate-intensity recreational activity has the greatest effects on the association between diabetes and depression, followed by vigorous-intensity recreational activity and SB. Interventions such as losing weight, achieving sufficient moderate-intensity recreational activity and reducing SB may be important.

10. Effectiveness of intervention program on the change of glycaemic control in diabetes with depression patients A meta-analysis of randomized controlled studies ¹⁰

(Primary Care Diabetes. 2021 Feb 5.)

This study aimed to probe the feasible way to improve glycaemic control in patients with comorbid diabetes and depression. Diabetes combined depression patients are a population which needs more attention. Cognitive behavioral therapy and mindful self-compassion of 0–6 months might be effective method to improve glycaemic control in diabetes with depression. Mindful self-compassion is more targeted.

BJSQ: Brief Job Stress Questionnaire; DM: Diabetes mellitus; MBSR: Mindfulness-based stress reduction; T2DM: Type 2 diabetes mellitus;
COVID-19: Coronavirus 2019