Depression linked to time of first severe hypoglycemic episode
Article originally posted on Healio by Katon, WJ, published in Annals of Family Medicine, May 20, 2013.
In adult patients with diabetes, the timing of first severe hypoglycemic episode and number of episodes were significantly associated with depression, according to researchers.
Previous research has revealed a link between depression and diabetes. In this study, Wayne J. Katon, MD, of the department of psychiatry at the University of Washington Medical School in Seattle, and colleagues sought to examine the prospective connection between depression and risk for severe hypoglycemic episodes that led to a medical emergency or hospitalization. They conducted a longitudinal 2-year study of 4,117 patients with diabetes (aged at least 18 years), making adjustments for sociodemographic, measurements of diabetes severity, medical comorbidities unrelated to diabetes, prior hypoglycemic episodes, and health risk behaviors (smoking and physical activity).
Patients with depression were more likely to be younger, female, unmarried and to be treated with insulin. They also had more nondiabetes-related medical comorbidities, a higher number of diabetes complications, higher BMI and rates of smoking, and they were less physically active.
According to data, patients with depression vs. those without depression displayed significantly higher risk for a severe hypoglycemic episode (HR=1.42; 95% CI, 1.03-1.96) and a higher amount of hypoglycemic episodes (RR=1.34; 95% CI, 1.03-1.74).
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“In the 5-year pre-baseline period, 8.1% of depressed patients with diabetes vs. 3.1% of non-depressed control patients with diabetes experienced one or more severe hypoglycemic episodes,” the researchers wrote. “Over the 5-year follow-up period, 6.9% of patients reported at least one severe hypoglycemic episode. A total of 10.7% of depressed patients with diabetes had one or more severe hypoglycemic episodes, compared with 6.4% among non-depressed control patients.”
After adjusting for confounders and clinical variables, researchers wrote that patients with depression had significantly shorter severe hypoglycemic episodes, but significantly more episodes. However, due to the study’s observational nature, researchers wrote there are limits on interpretations of causality. Further research is needed, they added.