Treating depression in type 2 diabetic patients improves depressive symptoms and quality of life but not metabolic control
J. Nicolau Ramis, C. Francés Artigas, R. Rivera Irigoin, J. Olivares Alcolea, A. Gil Palmer, L. Gómez Gómez, I. Rodriguez Rodriguez, B. Chacártegui Quetglas, J. Quevedo Juanals & L. Masmiquel Comas
Introduction:Type 2 Diabetes (T2DM) almost doubles the risk of comorbid depression, with lifetime prevalence up to 29%. It is important to recognize and treat depression in T2DM because its association with hyperglycemia, increased diabetic complications and poor quality of life (QoL) is well established. However, currently available medical therapy for depression is effective in reducing depressive symptoms, but does not consistently improves HbA1c levels. Aims:Determine the effects of antidepressant therapy on depressive symptoms, health-related QoL and metabolic control in T2DM. Material and methods:33 T2DM (47.8%♂, age 59.8±11.1, progression period of DM 9.5±6.5 years) who had a Beck Depression Inventory (BDI) test greater than 16 were prescribed citalopram 20 mg once daily; 10 out of 33 refused it. BDI score, BMI, HbA1c and the Spanish version of the SF-36 Health Survey were recorded baseline and after 6 months of treatment. Sociodemographic characteristics (marital status, educational level, labor situation), complications related to T2DM and comorbidities were also registered. Results:No differences in baseline characteristics were observed between the two groups. When compared with the untreated group (n=10), patients treated with citalopram (n=23) showed significant improvements in BDI score and in almost all areas of quality of life. No differences in HbA1c, waist circumference or BMI were seen (Table 1). Conclusions:Treating depressive symptoms with medical therapy in T2DM is associated with improvements in QoL and depression with lack of efficacy in metabolic control or weight.
Table 1 BMI: body mass index. BDI: Beck Depression Inventory
|Waist circumference(cm)||104±13||106±13||p= 0.091|
|HbA1c (%)||7.77±1.97||7.73±1.6||p= 0.923|
|General Health||42.54±21.68||48±24.63||p= 0.337|
|Physical Functioning||59.1±20.33||67.27±21.47||p= 0.042|
|Social Functioning||39.57±28.79||59.54±23.65||p= 0.002|
|Bodily Pain||60.68±27.8||59.5±27.61||p= 0.845|
|Mental Health||36.89±25.41||51.18±21.44||p= 0.012|
|Health Evolution||3.45±0.73||2.63±0.49||p= 0.000|
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.