1
|
Kim A, Jeon E, Lee H, Heo H, Woo K. Risk factors for prediabetes in community-dwelling adults: A generalized estimating equation logistic regression approach with natural language processing insights. Res Nurs Health 2024. [PMID: 38961672 DOI: 10.1002/nur.22413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 05/11/2024] [Accepted: 06/22/2024] [Indexed: 07/05/2024]
Abstract
The global prevalence of prediabetes is expected to reach 8.3% (587 million people) by 2045, with 70% of people with prediabetes developing diabetes during their lifetimes. We aimed to classify community-dwelling adults with a high risk for prediabetes based on prediabetes-related symptoms and to identify their characteristics, which might be factors associated with prediabetes. We analyzed homecare nursing records (n = 26,840) of 1628 patients aged over 20 years. Using a natural language processing algorithm, we classified each nursing episode as either low-risk or high-risk for prediabetes based on the detected number and category of prediabetes-symptom words. To identify differences between the risk groups, we employed t-tests, chi-square tests, and data visualization. Risk factors for prediabetes were identified using multiple logistic regression models with generalized estimating equations. A total of 3270 episodes (12.18%) were classified as potentially high-risk for prediabetes. There were significant differences in the personal, social, and clinical factors between groups. Results revealed that female sex, age, cancer coverage as part of homecare insurance coverage, and family caregivers were significantly associated with an increased risk of prediabetes. Although prediabetes is not a life-threatening disease, uncontrolled blood glucose can cause unfavorable outcomes for other major diseases. Thus, medical professionals should consider the associated symptoms and risk factors of prediabetes. Moreover, the proposed algorithm may support the detection of individuals at a high risk for prediabetes. Implementing this approach could facilitate proactive monitoring and early intervention, leading to reduced healthcare expenses and better health outcomes for community-dwelling adults.
Collapse
Affiliation(s)
- Aeri Kim
- College of Nursing, Seoul National University, Seoul, South Korea
| | - Eunjoo Jeon
- Technology Research, Samsung SDS, Seoul, South Korea
| | - Hana Lee
- College of Nursing, Seoul National University, Seoul, South Korea
| | - Hyunsook Heo
- Seoul National University Hospital, Seoul, South Korea
| | - Kyungmi Woo
- College of Nursing, Seoul National University, Seoul, South Korea
| |
Collapse
|
2
|
Khalil MAM, Sadagah NM, Tan J, Syed FO, Chong VH, Al-Qurashi SH. Pros and cons of live kidney donation in prediabetics: A critical review and way forward. World J Transplant 2024; 14:89822. [PMID: 38576756 PMCID: PMC10989475 DOI: 10.5500/wjt.v14.i1.89822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/11/2023] [Accepted: 01/16/2024] [Indexed: 03/15/2024] Open
Abstract
There is shortage of organs, including kidneys, worldwide. Along with deceased kidney transplantation, there is a significant rise in live kidney donation. The prevalence of prediabetes (PD), including impaired fasting glucose and impaired glucose tolerance, is on the rise across the globe. Transplant teams frequently come across prediabetic kidney donors for evaluation. Prediabetics are at risk of diabetes, chronic kidney disease, cardiovascular events, stroke, neuropathy, retinopathy, dementia, depression and nonalcoholic liver disease along with increased risk of all-cause mortality. Unfortunately, most of the studies done in prediabetic kidney donors are retrospective in nature and have a short follow up period. There is lack of prospective long-term studies to know about the real risk of complications after donation. Furthermore, there are variations in recommendations from various guidelines across the globe for donations in prediabetics, leading to more confusion among clinicians. This increases the responsibility of transplant teams to take appropriate decisions in the best interest of both donors and recipients. This review focuses on pathophysiological changes of PD in kidneys, potential complications of PD, other risk factors for development of type 2 diabetes, a review of guidelines for kidney donation, the potential role of diabetes risk score and calculator in kidney donors and the way forward for the evaluation and selection of prediabetic kidney donors.
Collapse
Affiliation(s)
- Muhammad Abdul Mabood Khalil
- Center of Renal Diseases and Transplantation, King Fahad Armed Forces Hospital Jeddah, Jeddah 23311, Saudi Arabia
| | - Nihal Mohammed Sadagah
- Center of Renal Diseases and Transplantation, King Fahad Armed Forces Hospital Jeddah, Jeddah 23311, Saudi Arabia
| | - Jackson Tan
- Department of Nephrology, RIPAS Hospital Brunei Darussalam, Brunei Muara BA1710, Brunei Darussalam
| | - Furrukh Omair Syed
- Center of Renal Diseases and Transplantation, King Fahad Armed Forces Hospital Jeddah, Jeddah 23311, Saudi Arabia
| | - Vui Heng Chong
- Division of Gastroenterology and Hepatology, Department of Medicine, Raja Isteri Pengiran Anak Saleha Hospital, Bandar Seri Begawan BA1710, Brunei Darussalam
| | - Salem H Al-Qurashi
- Center of Renal Diseases and Transplantation, King Fahad Armed Forces Hospital Jeddah, Jeddah 23311, Saudi Arabia
| |
Collapse
|
3
|
Mahmoud M, Mahmood R. Differences in mental health status between individuals living with diabetes, and pre-diabetes in Qatar: A cross-sectional study. Heliyon 2024; 10:e23515. [PMID: 38187308 PMCID: PMC10770440 DOI: 10.1016/j.heliyon.2023.e23515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 10/03/2023] [Accepted: 12/05/2023] [Indexed: 01/09/2024] Open
Abstract
Aims The aims of this study was to determine the prevalence and to compare depression and anxiety screening scores by type of diabetes: type 2 diabetes mellitus (T2DM), type 1 diabetes mellitus (T1DM), and pre-diabetes. The secondary aim was to examine sex differences in screening scores by type of diabetes. Methods This cross-sectional study was conducted in Doha, Qatar using primary data collection (N = 150), and stratified random sampling at a diabetes primary healthcare center. The study tool collected demographic information and used validated mental health screening tools for depressive symptoms "Patient Health Questionnaire-9 (PHQ-9)", and for anxiety symptoms "Generalized Anxiety Disorder 7 (GAD-7)". Results The prevalence of moderate to severe depressive and anxiety scores was highest in the prediabetes group (20 % and 14 % respectively). There were increased PHQ-9 scores in the pre-diabetes group compared to T2DM (p-value <0.05). No statistically significant differences in depressive symptom scores were found when comparing the pre-diabetes group with T1DM, and T1DM with T2DM. When looking at sex differences, there were no statistically significant differences between T1DM and pre-diabetes males and females, however PHQ-9 and GAD-7 scores in T2DM females were poorer compared to T2DM males. Conclusion The results of our study found patients living with pre-diabetes, and females with T2DM are vulnerable populations who should be screened for mental health disorders. Early screening for mental health disorders for individuals diagnosed with prediabetes, T1DM, and T2DM should be routinely conducted to potentially improve health outcomes.
Collapse
Affiliation(s)
- Montaha Mahmoud
- College of Health Sciences, University of Doha for Science and Technology, Doha, Qatar
| | - Razi Mahmood
- College of Health Sciences, University of Doha for Science and Technology, Doha, Qatar
- AFG College with the University of Aberdeen, Doha, Qatar
| |
Collapse
|
4
|
Possidente C, Fanelli G, Serretti A, Fabbri C. Clinical insights into the cross-link between mood disorders and type 2 diabetes: A review of longitudinal studies and Mendelian randomisation analyses. Neurosci Biobehav Rev 2023; 152:105298. [PMID: 37391112 DOI: 10.1016/j.neubiorev.2023.105298] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 05/15/2023] [Accepted: 06/26/2023] [Indexed: 07/02/2023]
Abstract
Mood disorders and type 2 diabetes mellitus (T2DM) are prevalent conditions that often co-occur. We reviewed the available evidence from longitudinal and Mendelian randomisation (MR) studies on the relationship between major depressive disorder (MDD), bipolar disorder and T2DM. The clinical implications of this comorbidity on the course of either condition and the impact of antidepressants, mood stabilisers, and antidiabetic drugs were examined. Consistent evidence indicates a bidirectional association between mood disorders and T2DM. T2DM leads to more severe depression, whereas depression is associated with more complications and higher mortality in T2DM. MR studies demonstrated a causal effect of MDD on T2DM in Europeans, while a suggestive causal association in the opposite direction was found in East Asians. Antidepressants, but not lithium, were associated with a higher T2DM risk in the long-term, but confounders cannot be excluded. Some oral antidiabetics, such as pioglitazone and liraglutide, may be effective on depressive and cognitive symptoms. Studies in multi-ethnic populations, with a more careful assessment of confounders and appropriate power, would be important.
Collapse
Affiliation(s)
- Chiara Possidente
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giuseppe Fanelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; Department of Human Genetics, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands
| | - Alessandro Serretti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
| | - Chiara Fabbri
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| |
Collapse
|
5
|
Arnardóttir E, Sigurðardóttir ÁK, Graue M, Kolltveit BCH, Skinner T. Can Waist-to-Height Ratio and Health Literacy Be Used in Primary Care for Prioritizing Further Assessment of People at T2DM Risk? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6606. [PMID: 37623189 PMCID: PMC10454465 DOI: 10.3390/ijerph20166606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/09/2023] [Accepted: 08/17/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND To identify people at risk of type 2 diabetes. Primary health care needs efficient and noninvasive screening tools to detect individuals in need of follow-up to promote health and well-being. Previous research has shown people with lower levels of health literacy and/or well-being scores are vulnerable but may benefit from intervention and follow-up care. AIMS This cross-sectional study, aimed to identify people at risk for type 2 diabetes by comparing the Finnish Diabetes Risk instrument with the waist-to-height ratio. Further, the difference was examined in health literacy and well-being scale scores in the countryside versus town areas, respectively. RESULTS In total, 220, aged 18-75 years, participated. Thereof, 13.2% displayed biomarkers at prediabetes level of HbA1c (39-47 mmol/mol); none had undiagnosed diabetes. Of the participants, 73% were overweight or obese. Waist-to-height ratio demonstrated 93.1% of the prediabetes group at moderate to high health risk and 64.4% of the normal group, with an area under the curve of 0.759, sensitivity of 93.3%, and specificity of 63.1%. Residency did not influence prediabetes prevalence, health literacy, or well-being. CONCLUSION Waist-to-height ratio and the Finnish Diabetes Risk instrument may be suitable for identifying who need further tests and follow-up care for health promotion in primary care.
Collapse
Affiliation(s)
- Elín Arnardóttir
- School of Health, Business and Natural Sciences, University of Akureyri, 600 Akureyri, Iceland
- Health Care Institution of North Iceland, 580 Siglufjordur, Iceland
| | - Árún K. Sigurðardóttir
- School of Health, Business and Natural Sciences, University of Akureyri, 600 Akureyri, Iceland
- Akureyri Hospital, 600 Akureyri, Iceland
| | - Marit Graue
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, 5063 Bergen, Norway
| | | | - Timothy Skinner
- Institute of Psychology, University of Copenhagen, 1017 Copenhagen K, Denmark
- Australian Centre for Behavioral Research in Diabetes, Melbourne, VIC 3053, Australia
| |
Collapse
|
6
|
French DP, Ahern AL, Greaves CJ, Hawkes RE, Higgs S, Pechey R, Sniehotta FF. Preventing type 2 diabetes: A research agenda for behavioural science. Diabet Med 2023; 40:e15147. [PMID: 37171753 PMCID: PMC10947238 DOI: 10.1111/dme.15147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/26/2023] [Accepted: 05/11/2023] [Indexed: 05/13/2023]
Abstract
AIMS The aim of this narrative review was to identify important knowledge gaps in behavioural science relating to type 2 diabetes prevention, to inform future research in the field. METHODS Seven researchers who have published behaviour science research applied to type 2 diabetes prevention independently identified several important gaps in knowledge. They met to discuss these and to generate recommendations to advance research in behavioural science of type 2 diabetes prevention. RESULTS A total of 21 overlapping recommendations for a research agenda were identified. These covered issues within the following broad categories: (a) evidencing the impact of whole population approaches to type 2 diabetes prevention, (b) understanding the utility of disease-specific approaches to type 2 diabetes prevention such as Diabetes Prevention Programmes (DPPs) compared to generic weight loss programmes, (c) identifying how best to increase reach and engagement of DPPs, whilst avoiding exacerbating inequalities, (d) the need to understand mechanism of DPPs, (e) the need to understand how to increase maintenance of changes as part of or following DPPs, (f) the need to assess the feasibility and effectiveness of alternative approaches to the typical self-regulation approaches that are most commonly used, and (g) the need to address emotional aspects of DPPs, to promote effectiveness and avoid harms. CONCLUSIONS There is a clear role for behavioural science in informing interventions to prevent people from developing type 2 diabetes, based on strong evidence of reach, effectiveness and cost-effectiveness. This review identifies key priorities for research needed to improve existing interventions.
Collapse
Affiliation(s)
- David P. French
- Manchester Centre of Health Psychology, Division of Psychology and Mental HealthUniversity of ManchesterManchesterUK
| | - Amy L. Ahern
- MRC Epidemiology Unit, School of Clinical MedicineUniversity of CambridgeCambridgeUK
| | - Colin J. Greaves
- School of Sport, Exercise and Rehabilitation SciencesUniversity of BirminghamBirminghamUK
| | - Rhiannon E. Hawkes
- Manchester Centre of Health Psychology, Division of Psychology and Mental HealthUniversity of ManchesterManchesterUK
| | - Suzanne Higgs
- School of PsychologyUniversity of BirminghamBirminghamUK
| | - Rachel Pechey
- Nuffield Department of Primary Care Health SciencesUniversity of OxfordOxfordUK
| | - Falko F. Sniehotta
- Division of Public Health, Social and Preventive Medicine, Center for Preventive Medicine and Digital Health (CPD)Universitätsmedizin Mannheim, Heidelberg UniversityHeidelbergGermany
- NIHR Policy Research Unit Behavioural ScienceNewcastle UniversityUK
| |
Collapse
|
7
|
An JH, Han KD, Jeon HJ. Higher metabolic variability increases the risk of depressive disorder in type 2 diabetes mellitus: a longitudinal nationwide cohort study. Front Psychiatry 2023; 14:1217104. [PMID: 37555004 PMCID: PMC10405173 DOI: 10.3389/fpsyt.2023.1217104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/05/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND AND OBJECTIVES While variabilities in metabolic parameters (METv) have been linked to adverse health outcomes in type 2 DM, their association with depression is yet to be studied. This research aimed to investigate the association between METv and depressive disorder in patients with type 2 DM. METHODS The study involved a nationwide cohort of 1,119,631 type 2 DM patients who had undergone three or more serial health examinations between 2005 and 2012. At each visit, body mass index (BMI), fasting glucose (FG), systolic blood pressure (BP), and total cholesterol (TC) were measured and stratified into quartiles, with Q4 being the highest and Q1 the lowest. The risk of depressive disorder was evaluated using Cox proportional hazard regression models, which accounted for METs in the indexes, after adjusting for sex, income status, lifestyle habits, medical comorbidities, DM severity, and baseline levels of BMI, FG, BP, and TC. RESULTS During a mean follow-up period of 6.00 ± 2.42 years, 239,477 (21.4%) cases of type 2 DM patients developed depressive disorder. The risk of developing depressive disorder was gradually increased as the number of METv increased (HR 1.18; 95% CI 1.13, 1.23 for the group with the highest METv in all parameters compared to those with the lowest METv in all parameters). In the subgroup analysis, the risk of developing depressive disorder was 43% higher in men (HR 1.43; 95% CI 1.34, 1.51), and 31% higher in those younger than 65 years of age (HR 1.31; 95% CI 1.23, 1.39) in the group with the highest number of METv compared to the group with the lowest number of METv. CONCLUSION In type 2 DM, higher METv was an independent risk factor for depressive disorder. This risk is notably elevated in men and individuals under the age of 65 years.
Collapse
Affiliation(s)
- Ji Hyun An
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyung-do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Health Sciences and Technology, Department of Medical Device Management and Research, Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea
| |
Collapse
|
8
|
Brown SA, Becker HA, García AA, Velasquez MM, Tanaka H, Winter MA, Perkison WB, Brown EL, Aguilar D, Hanis CL. The effects of gender and country of origin on acculturation, psychological factors, lifestyle factors, and diabetes-related physiological outcomes among Mexican Americans: The Starr County diabetes prevention initiative. Chronic Illn 2023; 19:444-457. [PMID: 35331025 PMCID: PMC9508285 DOI: 10.1177/17423953221089315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Examine acculturation and psychological, lifestyle, and physiological factors based on gender and country of origin (U.S. vs. Mexico). METHODS Baseline data from the Starr County diabetes prevention study (N = 300) were analyzed - acculturation (language), psychological factors (depression), lifestyle factors (sedentary behaviors), and diabetes-related physiological outcomes (insulin resistance). MANOVA and linear regression were used to examine variable relationships based on gender and country of origin and identify predictors of depression and insulin resistance. RESULTS Participants were: predominantly female (73%); 51 years of age, on average; born in Mexico (71%); and Spanish-speaking. Individuals spent 11 of their waking hours (range = 0-18 h) in sedentary activities. Compared to females, more males spoke English and reported fewer hours in sedentary activities. Compared to participants born in Mexico, those born in the U.S. were more likely to: speak English; report depressive symptoms; and exhibit elevated BMI and insulin resistance rates. Two distinct models significantly predicted depression (R2 = 14.5%) and insulin resistance (R2 = 26.8%), with acculturation-language entering into both models. DISCUSSION Significant gender and country-of-origin differences were found. Future research on diabetes prevention should examine other Hispanic subgroups and strategies for addressing individual differences, while employing cost-effective group interventions that incorporate these differences and reach more at-risk individuals.
Collapse
Affiliation(s)
- Sharon A Brown
- School of Nursing, 12330The University of Texas at Austin, Austin, TX, USA
| | - Heather A Becker
- School of Nursing, 12330The University of Texas at Austin, Austin, TX, USA
| | - Alexandra A García
- School of Nursing, 12330The University of Texas at Austin, Austin, TX, USA
| | - Mary M Velasquez
- 143057School of Social Work, The University of Texas at Austin, Austin, TX, USA
| | - Hirofumi Tanaka
- Department of Kinesiology & Health Education, College of Education, 12330The University of Texas at Austin, Austin, TX, USA
| | - Mary A Winter
- School of Nursing, 12330The University of Texas at Austin, Austin, TX, USA
| | - William B Perkison
- 49219School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Eric L Brown
- 49219School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - David Aguilar
- UK HealthCare, Department of Internal Medicine, 12252University of Kentucky, Lexington, KY, USA
| | - Craig L Hanis
- 49219School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| |
Collapse
|
9
|
Chen YH, Wang HN, Lang XE, Zhang XY. Prevalence and clinical correlates of abnormal glucose metabolism in young, first- episode and medication-naïve outpatients with major depressive disorder. Psychiatry Res 2023; 325:115250. [PMID: 37207542 DOI: 10.1016/j.psychres.2023.115250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/02/2023] [Accepted: 05/10/2023] [Indexed: 05/21/2023]
Abstract
BACKGROUNDS The high co-morbidity of abnormal glucose metabolism in depressed patients has been extensively studied, but few studies have explored abnormal glucose metabolism in young patients with major depressive disorder (MDD). This study aimed to examine the prevalence and clinical correlates of abnormal glucose metabolism in young patients with first-episode medication-naïve (FEMN) MDD. METHODS A cross-sectional study was conducted on 1289 young Chinese outpatients with FEMN MDD. All subjects were assessed on the Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale (HAMA), Positive and Negative Syndrome Scale, and their sociodemographic information was collected, and blood pressure, blood glucose, lipid and thyroid hormone levels were measured. RESULTS The prevalence of abnormal glucose metabolism was 12.57% in young FEMN MDD outpatients. Thyroid stimulating hormone (TSH) levels and HAMA scale scores were associated with fasting blood glucose levels in patients with FEMN MDD (P<0.05), and TSH could differentiate patients with abnormal normal glucose metabolism from those without abnormal glucose metabolism (Area Under Curve of 0.774). CONCLUSIONS Our study showed a high prevalence of comorbid glucose metabolism abnormalities in young FEMN MDD outpatients. TSH may be a promising biomarker of abnormal glucose metabolism in young patients with FEMN MDD.
Collapse
Affiliation(s)
- Yi-Huan Chen
- Department of Psychiatry, Xijing Hospital, Air Force Military Medical University, Xi'an, China
| | - Hua-Ning Wang
- Department of Psychiatry, Xijing Hospital, Air Force Military Medical University, Xi'an, China
| | - Xiao-E Lang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Xiang-Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
| |
Collapse
|
10
|
Deschênes SS, McInerney A, Nearchou F, Byrne B, Nouwen A, Schmitz N. Prediabetes and the risk of type 2 diabetes: Investigating the roles of depressive and anxiety symptoms in the Lifelines cohort study. Diabet Med 2023:e15061. [PMID: 36751973 DOI: 10.1111/dme.15061] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 12/22/2022] [Accepted: 02/01/2023] [Indexed: 02/09/2023]
Abstract
AIMS Depression and anxiety may increase the risk of progressing from prediabetes to type 2 diabetes. The present study examined the interactions between prediabetes status and elevated depressive and anxiety symptoms with the risk of type 2 diabetes. METHODS Participants (N = 72,428) were adults aged 40 years and above without diabetes at baseline from the Lifelines Cohort Study (58% female; mean age = 51.4 years). The Mini-International Neuropsychiatric Interview screened for elevated symptoms of major depressive disorder and generalized anxiety disorder. Glycated haemoglobin A1c (HbA1c ) levels determined prediabetes status at baseline (2007-2013), and HbA1c and self-reported diabetes diagnoses determined diabetes status at follow-up (2014-2017). Groups were formed for elevated depressive and anxiety symptoms, respectively, and prediabetes status at baseline (elevated depressive/anxiety symptoms with prediabetes, elevated depressive/anxiety symptoms alone, and prediabetes alone), and compared to a reference group (no prediabetes or anxiety/depression) on the likelihood of developing diabetes during the follow-up period. RESULTS N = 1300 (1.8%) participants developed diabetes. While prediabetes alone was associated with incident diabetes (OR = 5.94; 95% CI = 5.10-6.90, p < 0.001), the group with combined prediabetes and depressive symptoms had the highest likelihood of developing diabetes over follow-up (OR = 8.29; 95% CI = 5.58-12.32, p < 0.001). Similar results were found for prediabetes and anxiety symptoms (OR = 6.57; 95% CI = 4.62-9.33, p < 0.001), compared to prediabetes alone (OR = 6.09; 95% CI = 5.23-7.11, p < 0.001), though with a smaller effect. The interaction between depressive symptoms and prediabetes was synergistic in age-and-sex adjusted analyses. CONCLUSIONS Individuals with elevated depressive, and to some extent anxiety, symptoms in combination with prediabetes may represent a high-risk subgroup for type 2 diabetes.
Collapse
Affiliation(s)
| | - Amy McInerney
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Finiki Nearchou
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Brendan Byrne
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Arie Nouwen
- Department of Psychology, Middlesex University London, London, UK
| | - Norbert Schmitz
- Department of Population-Based Medicine, University of Tübingen, Tübingen, Germany
| |
Collapse
|
11
|
Vu TQC, Tran QK, Niu K. Association between serum 25 (OH) D levels and depression symptoms in adults with prediabetes. Diabetes Metab Syndr 2022; 16:102642. [PMID: 36279702 DOI: 10.1016/j.dsx.2022.102642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/05/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND AIM Depression symptoms are a significant risk factor for prediabetes-related diabetes, and low vitamin D levels are connected with depression symptoms. The goal of this study is to examine the association between vitamin D and depression symptoms in prediabetic persons. METHODS This cross-sectional survey was conducted in Tianjin, China, among 4051 individuals. Symptoms of depression were assessed using the Self-Rating Depression Scale (SDS) (cut-off point SDS ≥45). Serum 25 (OH) D concentrations were determined using an enzyme immunoassay (OCTEIA 25-hydroxy Vitamin D, IDS Ltd, UK) and classified into three levels: 50 nmol/L, 50-75 nmol/L, and >75 nmol/L. The link between serum 25 (OH) D concentrations and depression symptoms in prediabetes was investigated using multiple logistic regression analysis. The models were adjusted for a variety of potential confounders. RESULTS The prevalence of symptoms of depression in prediabetic adults was 14.2% (12.5% males and 16.4% females). After adjusting for potentially confounding variables, the odds ratios - ORs for symptoms of depression in women across serum 25 (OH) D levels were 1.00 (reference), 1.03 (0.57, 1.39), and 0.28 (0.12, 0.57), respectively (p = 0.0015). However, no statistically significant connection was discovered in males. CONCLUSION In women with prediabetes, we showed a substantial negative connection between serum 25 (OH) D levels and depressed symptoms. Vitamin D supplementation may be an effective way to decrease the risk of depression symptoms in women with prediabetes.
Collapse
Affiliation(s)
- Thi Quynh Chi Vu
- Nutrition Department, Dong A University, 33 Xo Viet Nghe Tinh, Hai Chau District, Danang, 550000, Viet Nam; Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, China.
| | - Quoc Kham Tran
- Administration of Science Technology and Training, Vietnam Ministry of Health, Hanoi 15000, Viet Nam
| | - Kaijun Niu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| |
Collapse
|
12
|
Fatigue, anxiety and depression in patients with prediabetes: a controlled cross-sectional study. Diabetol Int 2022; 13:631-636. [PMID: 36117928 PMCID: PMC9477980 DOI: 10.1007/s13340-022-00583-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 04/05/2022] [Indexed: 10/18/2022]
Abstract
Objective We aimed to determine fatigue, depression, anxiety levels, and quality of life (QoL) in patients with prediabetes (PD) and to compare them with healthy subjects. Materials and methods A controlled, cross-sectional study was conducted. The patients, aged 18-65, were recruited from a tertiary care hospital. A total of 105 patients with newly diagnosed untreated PD and 48 normoglycemic subjects were included in the study. Participants did not know the diagnosis of PD and did not give psychological distress to the newly diagnosed. All participants were evaluated for body mass index (BMI), oral glucose tolerance test (OGTT), glycated hemoglobin (HbA1c), Fatigue Severity Scale (FSS), Hospital Anxiety and Depression Scale (HADS), Short Form-36 (SF-36). Results Age, gender, BMI were similar between groups. The scores of psychological measures were significantly worse in patients with PD compared with normoglycemic subjects (FSS median score: 4.33 vs. 2.22, HADS-anxiety mean score: 7.53 vs. 2.64, HADS-depression mean score: 6.33 vs. 2.79, SF-36 total median score: 52.81 vs. 79.89). The FSS, HADS and SF-36 scores showed a weak but statistically significant relationship with BMI. OGTT, HbA1c and HOMA-IR did not show any relationship with these scores. Conclusion Psychosocial problems may present in the prediabetic stage before the onset of diabetes.
Collapse
|
13
|
Nübel J, Truthmann J, Heidemann C, Du Y, Paprott R, Hapke U, Kruse J, Scheidt-Nave C, Baumert J. Sex-specific impact of major depressive disorder on 12-year change in glycaemic status: Results from a nationwide cohort study of adults without diabetes in Germany. Diabet Med 2022; 39:e14767. [PMID: 34890066 DOI: 10.1111/dme.14767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 11/11/2021] [Accepted: 12/08/2021] [Indexed: 12/01/2022]
Abstract
AIMS There is evidence for an increased type 2 diabetes (T2D) risk associated with depression, but its role for diabetes prevention remains unclear. This study aimed to add insight by investigating the impact of major depressive disorder (MDD) on prospective glycaemic changes. METHODS The study was based on a cohort of n = 1,766 adults without diabetes (776 men, 990 women; 18-65 years of age) who participated in the mental health supplement of the German National Health Interview and Examination Survey (GNHIES98-MHS, 1997-1999) and in a follow-up survey (DEGS1, 2008-2011). Glycaemic status was defined as normoglycaemia [HbA1c < 39 mmol/mol (<5.7%)], prediabetes [39 ≤ HbA1c < 48 mmol/mol (5.7-6.4%)] and diabetes [HbA1c ≥ 48 mmol/mol (≥ 6.5%), diagnosed diabetes, or antidiabetic medication], and glycaemic changes categorized as 'remission', 'stability' and 'progression'. Baseline MDD was assessed via a modified German version of the WHO Composite International Diagnostic Interview. Multivariable logistic regressions were applied to analyse the association of MDD with glycaemic changes and incident T2D, adjusting for socio-demographics, lifestyle conditions, chronic diseases, antidepressant use and mental health care. RESULTS MDD prevalence was 21.4% for women and 8.9% for men. Among women, MDD was associated with a lower chance for remission (RRR 0.43; 95% CI 0.23, 0.82). Among men, MDD was not significantly related to glycaemic changes. MDD had no significant effect on incident T2D (men: OR 1.58; 0.55, 4.52; women: OR 0.76; 0.37, 1.58). CONCLUSIONS Findings of the current study highlight the role of depression in T2D prevention, particularly among women.
Collapse
Affiliation(s)
- Julia Nübel
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Julia Truthmann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
- Department of Family Medicine, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Christin Heidemann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Yong Du
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Rebecca Paprott
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Ulfert Hapke
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Johannes Kruse
- Department of Psychosomatic Medicine and Psychotherapy, University of Giessen, Giessen, Germany
- Department of Psychosomatic Medicine and Psychotherapy, University of Marburg, Marburg, Germany
| | - Christa Scheidt-Nave
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Jens Baumert
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| |
Collapse
|
14
|
Mainous AG, Rooks BJ, Orlando FA. Is There Limited Utility for Lifestyle Recommendations for Diabetes Prevention Among Overweight or Obese Depressed Patients? Front Med (Lausanne) 2021; 8:757250. [PMID: 34869458 PMCID: PMC8639493 DOI: 10.3389/fmed.2021.757250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/29/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Lifestyle interventions like diet and exercise are commonly recommended for diabetes prevention, but it is unclear if depression modifies the likelihood of adherence. We evaluated the relationship between high depressive symptomatology and adherence to lifestyle interventions among patients with pre-diabetes. Methods: We conducted an analysis of the nationally representative National Health and Nutrition Examination Survey (NHANES) 2017-2018. Adults, aged ≥18 years old who were overweight or obese (BMI ≥25) and had diagnosed or undiagnosed pre-diabetes (HbA1c 5.7-6.4) were included. Depressive symptomatology was classified by the Patient Health Questionniare-9 (PHQ-9). We used self-reported adherence to physician suggested lifestyle changes of diet and exercise. Results: In this nationally representative survey of overweight or obese adults with pre-diabetes, 14.8% also have high depressive symptomatology. In unadjusted analyses, an interaction was observed with high depressive symptomatology acting as an effect modifier for adherence to exercise oriented interventions among patients with diagnosed pre-diabetes (p = 0.027). In logistic regressions, adjusting for age, sex, race, outpatient medical care in the past 12 months, and obesity, among patients with diagnosed pre-diabetes, depressed patients were less likely to attempt to exercise more (OR = 0.31; 95% CI: 0.10, 0.94) and no association between high depressive symptomatology and attempting to lose weight was observed (OR = 0.45; 95% CI: 0.14, 1.42). Conclusions: The findings of this nationally representative study of US adults, high depressive symptomatology decreases the likelihood of adherence to exercise based lifestyle recommendations among patients with diagnosed pre-diabetes.
Collapse
Affiliation(s)
- Arch G Mainous
- Department of Health Services Research, Management and Policy, University of Florida, Gainesville, FL, United States.,Department of Community Health and Family Medicine, University of Florida, Gainesville, FL, United States
| | - Benjamin J Rooks
- Department of Community Health and Family Medicine, University of Florida, Gainesville, FL, United States
| | - Frank A Orlando
- Department of Community Health and Family Medicine, University of Florida, Gainesville, FL, United States
| |
Collapse
|
15
|
Ochi R, Fujita N, Goto N, Takaishi K, Oshima T, Nguyen ST, Nishijo H, Urakawa S. Medial prefrontal area reductions, altered expressions of cholecystokinin, parvalbumin, and activating transcription factor 4 in the corticolimbic system, and altered emotional behavior in a progressive rat model of type 2 diabetes. PLoS One 2021; 16:e0256655. [PMID: 34506507 PMCID: PMC8432800 DOI: 10.1371/journal.pone.0256655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/11/2021] [Indexed: 12/14/2022] Open
Abstract
Metabolic disorders are associated with a higher risk of psychiatric disorders. We previously reported that 20-week-old Otsuka Long-Evans Tokushima fatty (OLETF) rats, a model of progressive type 2 diabetes, showed increased anxiety-like behavior and regional area reductions and increased cholecystokinin-positive neurons in the corticolimbic system. However, in which stages of diabetes these alterations in OLETF rats occur remains unclear. We aimed to investigate anxiety-like behavior and its possible mechanisms at different stages of type 2 diabetes in OLETF rats. Eight- and 30-week-old OLETF rats were used as diabetic animal models at the prediabetic and progressive stages of type 2 diabetes respectively, and age-matched Long-Evans Tokushima Otsuka rats served as non-diabetic controls. In the open-field test, OLETF rats showed less locomotion in the center zone and longer latency to leave the center zone at 8 and 30 weeks old, respectively. The areas of the medial prefrontal cortex were smaller in the OLETF rats, regardless of age. The densities of cholecystokinin-positive neurons in OLETF rats were higher in the lateral and basolateral amygdala only at 8 weeks old and in the anterior cingulate and infralimbic cortices and hippocampal cornu ammonis area 3 at both ages. The densities of parvalbumin-positive neurons of OLETF rats were lower in the cornu ammonis area 2 at 8 weeks old and in the prelimbic and infralimbic cortices at both ages. No apoptotic cell death was detected in OLETF rats, but the percentage of neurons co-expressing activating transcription factor 4 and cholecystokinin and parvalbumin was higher in OLETF rats at both ages in the anterior cingulate cortex and basolateral amygdala, respectively. These results suggest that altered emotional behavior and related neurological changes in the corticolimbic system are already present in the prediabetic stage of OLETF rats.
Collapse
Affiliation(s)
- Ryosuke Ochi
- Department of Musculoskeletal Functional Research and Regeneration, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Naoto Fujita
- Department of Musculoskeletal Functional Research and Regeneration, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Natsuki Goto
- Department of Musculoskeletal Functional Research and Regeneration, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Kaho Takaishi
- Department of Musculoskeletal Functional Research and Regeneration, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Takaya Oshima
- Department of Musculoskeletal Functional Research and Regeneration, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Son Tien Nguyen
- Department of Musculoskeletal Functional Research and Regeneration, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Hisao Nishijo
- System Emotional Science, Faculty of Medicine, University of Toyama, Sugitani, Toyama, Japan
| | - Susumu Urakawa
- Department of Musculoskeletal Functional Research and Regeneration, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
- * E-mail:
| |
Collapse
|
16
|
Memory impairment and depressive-like phenotype are accompanied by downregulation of hippocampal insulin and BDNF signaling pathways in prediabetic mice. Physiol Behav 2021; 237:113346. [DOI: 10.1016/j.physbeh.2021.113346] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 01/23/2021] [Accepted: 01/29/2021] [Indexed: 12/19/2022]
|
17
|
Atasoy S, Johar H, Herder C, Rathmann W, Koenig W, Roden M, Peters A, Kruse J, Ladwig KH. Generalized anxiety disorder symptoms and type 2 diabetes onset: Findings from the Prospective Cooperative Health Research in the Region of Augsburg F4 and FF4 studies. J Psychosom Res 2021; 145:110480. [PMID: 33865610 DOI: 10.1016/j.jpsychores.2021.110480] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 03/26/2021] [Accepted: 03/28/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To investigate the association of generalized anxiety disorder (GAD) symptomology on the incidence of type 2 diabetes. RESEARCH DESIGN & METHODS Participants from the prospective KORA F4/FF4 German cohort were followed for a mean of 6.5 years. Generalized Anxiety Disorder Scale-7 (GAD-7) was used to assess GAD symptoms and incident type 2 diabetes cases were confirmed using a standard oral glucose tolerance test. Multivariate logistic regression models were used to estimate the effect of GAD symptoms on the incidence of type 2 diabetes. RESULTS The present study included 1694 participants (51.8% women, 48.2% men) with a mean age of 51.2 years, among whom 113 (6.7%) had high GAD symptoms. During the follow-up period (11,102 person/years), 113 (6.5%) type 2 diabetes cases were confirmed. Participants with GAD symptoms had 2-fold higher incidence of type 2 diabetes than participants without GAD (17.7 vs. 8.7 cases/1000 person-years). Correspondingly, GAD symptoms independently increased the risk of type 2 diabetes by an odds ratio of 2.09 [95%CI 1.02-4.32, p = 0.04] after adjustment for concurrent sociodemographic, lifestyle and cardiometabolic risk factors, high sensitivity C-reactive protein, depression, and the use of antidepressant medications. Additionally, GAD symptoms had an even larger impact on the onset of type 2 diabetes incidence following additional adjustment for prediabetes at baseline (2.68 [1.23-5.88], p=0.01). CONCLUSIONS Participants with GAD symptoms had 2-times higher odds of type 2 diabetes incidence during 6.5 years of follow-up, highlighting the significant role of dysregulated stress mechanisms in the pathway to developing type 2 diabetes.
Collapse
Affiliation(s)
- Seryan Atasoy
- Department of Psychosomatic Medicine and Psychotherapy, University of Gießen and Marburg, Germany; Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; German Center for Diabetes Research (DZD), Partner Helmholtz Zentrum München, Germany
| | - Hamimatunnisa Johar
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; German Center for Diabetes Research (DZD), Partner Helmholtz Zentrum München, Germany
| | - Christian Herder
- German Center for Diabetes Research (DZD), Partner Düsseldorf, Germany; Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Wolfgang Rathmann
- German Center for Diabetes Research (DZD), Partner Düsseldorf, Germany; Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Wolfgang Koenig
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; German Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany; Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany
| | - Michael Roden
- German Center for Diabetes Research (DZD), Partner Düsseldorf, Germany; Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; German Center for Diabetes Research (DZD), Partner Helmholtz Zentrum München, Germany
| | - Johannes Kruse
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; German Center for Diabetes Research (DZD), Partner Helmholtz Zentrum München, Germany
| | - Karl-Heinz Ladwig
- Department of Psychosomatic Medicine and Psychotherapy, University of Gießen and Marburg, Germany; Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; German Center for Diabetes Research (DZD), Partner Helmholtz Zentrum München, Germany.
| |
Collapse
|
18
|
Ferri F, Deschênes SS, Power N, Schmitz N. Associations between cognitive function, metabolic factors and depression: A prospective study in Quebec, Canada. J Affect Disord 2021; 283:77-83. [PMID: 33524662 DOI: 10.1016/j.jad.2021.01.039] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 12/09/2020] [Accepted: 01/09/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Metabolic risk factors, low cognitive function and history of depression are known risk factors for future depressive episodes. This paper aims to evaluate the potential interactions between these factors on the risk of a major depressive episodes in middle-age. METHODS Baseline and follow-up data from a population-based study of Quebec, Canada were used. The sample consisted of 1788 adults between 40 and 69 years of age without diabetes. Cognitive function and metabolic risk factors were assessed at baseline. Three cognitive domains were assessed: processing speed, episodic memory and executive function. History of depression was assessed five years later by a clinical interview. Logistic regression analysis was conducted to evaluate interactions between individual metabolic factors, low cognitive function, and depression history. RESULTS Participants with a comorbidity of at least one metabolic factor, history of depression and low cognitive function had the highest risk of experiencing a depressive episode in middle age. The highest risk was observed in individuals with abdominal obesity, low cognitive function, and a history of depression (OR= 8.66, 95% CI 3.83-19.59). The risks for those with abdominal obesity only, depression history only, and low cognitive function were 1.20 (95%CI 0.71-2.02), 3.10 (95%CI 1.81-5.24), and 1.39 (95%CI 0.72-2.67), respectively. LIMITATIONS Depression was only assessed at follow-up. CONCLUSION Metabolic risk factors comorbid with low cognitive function in middle-aged individuals with a history of depression were associated with an increased risk of a future depressive episode. This study highlights the importance of screening for metabolic and cognitive comorbidities in patients with a history of depression.
Collapse
Affiliation(s)
- Floriana Ferri
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada; Douglas University Mental Health Institute, Montreal, QC, Canada
| | - Sonya S Deschênes
- Douglas University Mental Health Institute, Montreal, QC, Canada; School of Psychology, University College Dublin, Dublin, Ireland
| | - Niamh Power
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada; Douglas University Mental Health Institute, Montreal, QC, Canada
| | - Norbert Schmitz
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada; Douglas University Mental Health Institute, Montreal, QC, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada; Montreal Diabetes Research Centre, Montreal, QC, Canada.
| |
Collapse
|
19
|
Stark EL, Miller ES. Diabesity and Perinatal Mental Health: Evidence-based Recommendations for Screening and Intervention. Clin Obstet Gynecol 2020; 64:204-213. [PMID: 33284142 DOI: 10.1097/grf.0000000000000586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Perinatal mental illness, obesity, and diabetes mellitus are common complications of the perinatal period that are becoming ever more prevalent and frequently co-occur. This review seeks to examine the prevalence of comorbid obesity/diabetes (termed "diabesity") and mental illness in the perinatal period and current understandings of the psychosocial and pathophysiological relationships between these diseases. We will present current guidelines for screening and make recommendations for adaptations of mental health treatment in patients with this comorbidity. Finally, we present future directions for research and clinical intervention.
Collapse
Affiliation(s)
| | - Emily S Miller
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| |
Collapse
|
20
|
Raja SY, Ghori U, Naqvi HA, Aijaz S, Anwar A, Hashmi AA. Factors for Social Stressors Among Type 2 Diabetics Versus Non-Diabetics Using the Hamilton Depression Rating Scale. Cureus 2020; 12:e11861. [PMID: 33409095 PMCID: PMC7781553 DOI: 10.7759/cureus.11861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective This study aimed to evaluate different factors of social stressors among people with type II diabetes versus non-diabetics by using the Hamilton Depression Rating Scale (HAM-D). Methodology This case-control study was done for one year at Ziauddin University Hospital, Karachi, Pakistan. Diagnosed patients with type II diabetes between 25 and 60 years were included as cases and age-related healthy individuals as controls. Participants on any psychotropic medications, neurodegenerative disorders, or on chemotherapy were excluded. Hamilton Rating Scale for Depression (HRDS-17) was used for recording depressive symptoms. The Statistical Package for the Social Sciences (SPSS) version 26.0 (IBM Corp., Armonk, NY) was used for data analysis. The frequency was calculated for descriptive statistics and depression scores (HRDS-17). A significance level of 0.05 was considered. Results A total of 272 patients were divided into two groups, with 136 patients in the group with diabetes and 136 participants in the control group. The mean age among people with diabetes was 55.13±9.10 years and among non-diabetics was 43.25±12.97 years (p<0.001). The mean duration of illness in people with diabetes was 8.51±7.57 years and in non-diabetics, it was 6.73±4.42 years (p=0.018). The mean social rating in people with diabetes was 164.0±155.60 and in non-diabetics, it was 124.75±99.02 (p=0.014). Insomnia, both in the early and middle part of the night affecting work activities, hypochondriasis, and loss of weight, was significantly present among diabetics as compared to controls (p<0.05). Conclusion Most diabetics reported a significant effect on the quality of life based on social rating and health-care expenditure. They experienced depressive symptoms more frequently than non-diabetics. Insomnia in the middle of the night affected work and activities; hypochondriasis and weight loss were found to be substantially higher among patients with diabetes than in controls.
Collapse
Affiliation(s)
- Saadia Y Raja
- Internal Medicine, Ziauddin University, Karachi, PAK
| | - Uzma Ghori
- Internal Medicine, Ziauddin University, Karachi, PAK
| | | | - Sadaf Aijaz
- Psychiatry, Northern Border University, Arar, SAU
| | - Adnan Anwar
- Physiology, Al-Tibri Medical College, Isra University, Karachi, PAK
| | - Atif A Hashmi
- Pathology, Liaquat National Hospital and Medical College, Karachi, PAK
| |
Collapse
|
21
|
Yuan S, Larsson SC. An atlas on risk factors for type 2 diabetes: a wide-angled Mendelian randomisation study. Diabetologia 2020; 63:2359-2371. [PMID: 32895727 PMCID: PMC7527357 DOI: 10.1007/s00125-020-05253-x] [Citation(s) in RCA: 118] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 07/10/2020] [Indexed: 02/08/2023]
Abstract
AIMS/HYPOTHESIS The aim of this study was to use Mendelian randomisation (MR) to identify the causal risk factors for type 2 diabetes. METHODS We first conducted a review of meta-analyses and review articles to pinpoint possible risk factors for type 2 diabetes. Around 170 possible risk factors were identified of which 97 risk factors with available genetic instrumental variables were included in MR analyses. To reveal more risk factors that were not included in our MR analyses, we conducted a review of published MR studies of type 2 diabetes. For our MR analyses, we used summary-level data from the DIAbetes Genetics Replication And Meta-analysis consortium (74,124 type 2 diabetes cases and 824,006 controls of European ancestry). Potential causal associations were replicated using the FinnGen consortium (11,006 type 2 diabetes cases and 82,655 controls of European ancestry). The inverse-variance weighted method was used as the main analysis. Multivariable MR analysis was used to assess whether the observed associations with type 2 diabetes were mediated by BMI. We used the Benjamini-Hochberg method that controls false discovery rate for multiple testing. RESULTS We found evidence of causal associations between 34 exposures (19 risk factors and 15 protective factors) and type 2 diabetes. Insomnia was identified as a novel risk factor (OR 1.17 [95% CI 1.11, 1.23]). The other 18 risk factors were depression, systolic BP, smoking initiation, lifetime smoking, coffee (caffeine) consumption, plasma isoleucine, valine and leucine, liver alanine aminotransferase, childhood and adulthood BMI, body fat percentage, visceral fat mass, resting heart rate, and four plasma fatty acids. The 15 exposures associated with a decreased risk of type 2 diabetes were plasma alanine, HDL- and total cholesterol, age at menarche, testosterone levels, sex hormone binding globulin levels (adjusted for BMI), birthweight, adulthood height, lean body mass (for women), four plasma fatty acids, circulating 25-hydroxyvitamin D and education years. Eight associations remained after adjustment for adulthood BMI. We additionally identified 21 suggestive risk factors (p < 0.05), such as alcohol consumption, breakfast skipping, daytime napping, short sleep, urinary sodium, and certain amino acids and inflammatory factors. CONCLUSIONS/INTERPRETATION The present study verified several previously reported risk factors and identified novel potential risk factors for type 2 diabetes. Prevention strategies for type 2 diabetes should be considered from multiple perspectives on obesity, mental health, sleep quality, education level, birthweight and smoking.
Collapse
Affiliation(s)
- Shuai Yuan
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Nobelsväg 13, 17177, Stockholm, Sweden
| | - Susanna C Larsson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Nobelsväg 13, 17177, Stockholm, Sweden.
- Department of Surgical Sciences, Uppsala University, Dag Hammarskjölds Väg 14B, 75185, Uppsala, Sweden.
| |
Collapse
|
22
|
Jiang L, Atasoy S, Johar H, Herder C, Peters A, Kruse J, Ladwig KH. Anxiety boosts progression of prediabetes to type 2 diabetes: findings from the prospective Cooperative Health Research in the Region of Augsburg F4 and FF4 studies. Diabet Med 2020; 37:1737-1741. [PMID: 31943340 DOI: 10.1111/dme.14232] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/09/2020] [Indexed: 01/14/2023]
Abstract
AIM To investigate the association between anxiety symptoms and the progression from prediabetes to type 2 diabetes. METHODS A sample of 1708 participants aged 31-82 years from the population-based Cooperative Health Research in the Region of Augsburg F4 and the follow-up Cooperative Health Research in the Region of Augsburg FF4 studies was included. Prediabetes was defined as impaired fasting glucose and/or impaired glucose tolerance, and anxiety status was measured by the generalized anxiety disorder-7 questionnaire. Newly diagnosed type 2 diabetes cases were identified after 6.5 years (11 102 person-years) and confirmed by medical records. Multivariate logistic regression analyses were employed to estimate the effect of prediabetes and anxiety on the incidence of type 2 diabetes with different levels of adjustments for potential confounders. The population attributable risk of type 2 diabetes in participants with prediabetes and anxiety was estimated. RESULTS Prediabetes at baseline was prevalent in 247 participants, of whom 77 developed diabetes after follow-up, accounting for a progression rate of 31%. In participants with prediabetes, high anxiety was associated with a 3-fold increased risk of progression to type 2 diabetes in comparison with low anxiety, even after accounting for socio-demographic, lifestyle and metabolic risk factors (OR = 2.82, 95% CI = 0.95-8.37, P = 0.06). A significant proportion of incident type 2 diabetes was attributed to having anxiety in addition to prediabetes (attributable risk proportion: 0.52; 95% CI = 0.004-1.04, P = 0.05). CONCLUSIONS Anxiety symptoms independently increase the progression risk of prediabetes to type 2 diabetes and should be routinely considered alongside the traditional risk factors in people with prediabetes.
Collapse
Affiliation(s)
- L Jiang
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - S Atasoy
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Department of Psychosomatic Medicine and Psychotherapy, University of Gießen and Marburg, Gießen, Germany
| | - H Johar
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Department of Psychosomatic Medicine and Psychotherapy, University of Gießen and Marburg, Gießen, Germany
| | - C Herder
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - A Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - J Kruse
- Department of Psychosomatic Medicine and Psychotherapy, University of Gießen and Marburg, Gießen, Germany
| | - K-H Ladwig
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, München, Germany
| |
Collapse
|
23
|
Bell K, Shaw JE, Maple-Brown L, Ferris W, Gray S, Murfet G, Flavel R, Maynard B, Ryrie H, Pritchard B, Freeman R, Gordon BA. A position statement on screening and management of prediabetes in adults in primary care in Australia. Diabetes Res Clin Pract 2020; 164:108188. [PMID: 32360708 DOI: 10.1016/j.diabres.2020.108188] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 04/06/2020] [Accepted: 04/27/2020] [Indexed: 12/16/2022]
Abstract
Prediabetes has a high prevalence, with early detection essential to facilitate optimal management to prevent the development of conditions such as type 2 diabetes and cardiovascular disease. Prediabetes can include impaired fasting glucose, impaired glucose tolerance and elevated HbA1c. This position statement outlines the approaches to screening and management of prediabetes in primary care. There is good evidence to implement intensive, structured lifestyle interventions for individuals with impaired glucose tolerance. The evidence for those with impaired fasting glucose or elevated HbA1c is less clear, but individuals should still be provided with generalised healthy lifestyle strategies. A multidisciplinary approach is recommended to implement healthy lifestyle changes through education, nutrition and physical activity. Individuals should aim to lose weight (5-10% of body mass) using realistic and sustainable dietary approaches supported by an accredited practising dietitian, where possible. Physical activity and exercise should be used to facilitate weight maintenance and reduce blood glucose. Moderate-vigorous intensity aerobic exercise and resistance training should be prescribed by an accredited exercise physiologist, where possible. When indicated, pharmacotherapy, metabolic surgery and psychosocial care should be considered, in order to enhance the outcomes associated with lifestyle change. Individuals with prediabetes should generally be evaluated annually for their diabetes status.
Collapse
Affiliation(s)
- Kirstine Bell
- Charles Perkins Centre and School of Life and Environmental Sciences, University of Sydney, NSW, Australia
| | | | - Louise Maple-Brown
- Menzies School of Health Research, NT, Australia; Department of Endocrinology, Royal Darwin Hospital, Australia
| | - Wendy Ferris
- Diabetes Service, Hunter New England Local Health District, NSW, Australia
| | - Susan Gray
- Pharmaceutical Society of Australia & University of Queensland, QLD, Australia
| | - Giuliana Murfet
- Diabetes Centre, Tasmanian Health Service - North West, TAS, Australia; Deakin University, VIC, Australia
| | | | | | - Hannah Ryrie
- Dietitians Association of Australia, ACT, Australia
| | | | - Rachel Freeman
- Australian Diabetes Educators Association, ACT, Australia
| | - Brett A Gordon
- Holsworth Research Initiative, La Trobe University, VIC, Australia.
| |
Collapse
|
24
|
Peleg O, Cohen A, Haimov I. Depressive symptoms mediate the relationship between sleep disturbances and type 2 diabetes mellitus. J Diabetes 2020; 12:305-314. [PMID: 31626387 DOI: 10.1111/1753-0407.12996] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 08/25/2019] [Accepted: 10/14/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The current study aimed at examining whether individuals diagnosed with type 2 diabetes mellitus (T2DM) have more severe sleep disturbances compared to individuals who are healthy or have prediabetes and whether depressive symptoms mediate the relationship between sleep disturbances and having T2DM. METHODS T2DM patients (n = 107) were compared to individuals with prediabetes (n = 48) and healthy individuals (n = 154) regarding the severity of depressive symptoms, measured via the Beck Depression Inventory-II (BDI-II), and sleep disturbances, measured via the Mini Sleep Questionnaire (MSQ). Mediation analysis examined whether depressive symptoms mediated the relationship between sleep disturbances and T2DM. RESULTS Compared to healthy individuals and individuals with prediabetes, T2DM patients had more depressive symptoms and higher levels of insomnia, hypersomnia, and overall more sleep disturbances. The prediabetes group did not differ from the healthy control group on these measures, and these groups were thus combined for further analysis. Sleep disturbances were correlated with severity of depressive symptoms (r =0.43). After controlling for age, gender, and ethnic background, both severity of sleep disturbances (odds ratio [OR]: 1.04; 95% CI: 1.01-1.07, P <.001) and severity of depressive symptoms (OR: 8.54, 95% CI: 3.37-21.69, P <.001) predicted T2DM. Depression symptoms mediated the relationship between sleep disturbances and T2DM, whereas the direct relationship between sleep disturbances and T2DM was nonsignificant. CONCLUSIONS The findings imply that sleep disturbances may contribute to the development and progression of T2DM by promoting depressive symptoms. Thus, treatments for the emotional distress associated with sleep disturbances may help reduce the risk for T2DM and the progression of the disease.
Collapse
Affiliation(s)
- Ora Peleg
- Department of Education, The Max Stern Yezreel Valley College, Emek Yezreel, Israel
| | - Ami Cohen
- Department of Psychology, The Max Stern Yezreel Valley College, Emek Yezreel, Israel
| | - Iris Haimov
- Department of Psychology, The Max Stern Yezreel Valley College, Emek Yezreel, Israel
| |
Collapse
|
25
|
Hafez D, Heisler M, Choi H, Ankuda CK, Winkelman T, Kullgren JT. Association Between Purpose in Life and Glucose Control Among Older Adults. Ann Behav Med 2019; 52:309-318. [PMID: 30084896 DOI: 10.1093/abm/kax012] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Greater purpose in life is associated with lower rates of certain chronic diseases. Whether purpose in life can protect against development of prediabetes or type 2 diabetes is unknown. Purpose To examine the association between purpose in life and blood glucose control among adults ≥50 years. Methods We conducted a longitudinal cohort study of 3,907 participants of the Health and Retirement Study who at baseline did not have type 2 diabetes or prediabetes. Baseline purpose in life was measured using the Ryff and Keyes' Scales of Psychological Well-Being and grouped into tertiles (high, medium, and low). We used multivariable linear regression to examine the association between baseline purpose in life and HbA1c over 4 years. Multivariable logistic regression was used to examine the association between baseline purpose and incident prediabetes or type 2 diabetes over the same period. Results After adjusting for sociodemographic factors, body mass index, physical activity, and physical and mental health factors, HbA1c was 0.07 percentage points lower among participants with high purpose than those with low purpose (95% confidence interval [CI] -0.12 to -0.02; p = .011). Participants with high purpose had lower odds of developing prediabetes or type 2 diabetes than those with low purpose (adjusted odds ratio 0.78; 95% CI 0.62 to 0.98; p = .037). Conclusions Among older adults, greater purpose in life is associated with a lower incidence of prediabetes or type 2 diabetes. Strategies to promote greater purpose in life should be tested as a part of type 2 diabetes prevention efforts.
Collapse
Affiliation(s)
- Dina Hafez
- Robert Wood Johnson Foundation Clinical Scholars Program, University of Michigan, Ann Arbor, MI, USA.,VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.,University of Michigan Medical School, Ann Arbor, MI, USA.,University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI, USA
| | - Michele Heisler
- Robert Wood Johnson Foundation Clinical Scholars Program, University of Michigan, Ann Arbor, MI, USA.,VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.,University of Michigan Medical School, Ann Arbor, MI, USA.,University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI, USA
| | - HwaJung Choi
- Robert Wood Johnson Foundation Clinical Scholars Program, University of Michigan, Ann Arbor, MI, USA.,University of Michigan Medical School, Ann Arbor, MI, USA.,University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI, USA
| | - Claire K Ankuda
- Robert Wood Johnson Foundation Clinical Scholars Program, University of Michigan, Ann Arbor, MI, USA.,University of Michigan Medical School, Ann Arbor, MI, USA.,University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI, USA
| | - Tyler Winkelman
- Robert Wood Johnson Foundation Clinical Scholars Program, University of Michigan, Ann Arbor, MI, USA.,VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.,University of Michigan Medical School, Ann Arbor, MI, USA.,University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI, USA
| | - Jeffrey T Kullgren
- VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.,University of Michigan Medical School, Ann Arbor, MI, USA.,University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI, USA
| |
Collapse
|
26
|
Cohen A, Peleg O, Sarhana A, Lam S, Haimov I. Depressive Symptoms Mediate the Relationship between Emotional Cutoff and Type 2 Diabetes Mellitus. Int J Behav Med 2019; 26:591-599. [PMID: 31515774 DOI: 10.1007/s12529-019-09816-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Differentiation of self is a family systems construct defined as the ability to balance intimacy and autonomy and to separate instinctually driven emotional reactions and thoughtfully considered goal-directed functioning. In theory, low differentiation of self is reflected by four components: a low tendency to take an I-position in relationships (i.e., to own one's thoughts and feelings); emotional cutoff from others; a greater tendency to fuse with others; and a tendency towards emotional reactivity. Low differentiation of self is associated with anxiety and depression, which are risk factors for type 2 diabetes mellitus. The current study examines the relationship between differentiation of self and type 2 diabetes mellitus. METHOD Individuals with type 2 diabetes mellitus (N = 107) and healthy individuals (N = 145) completed the Differentiation of Self Inventory-Revised (DSI-R), the State-Trait Anxiety Inventory (STAI), and the Beck Depression Inventory (BDI-II). RESULTS Compared with healthy individuals, participants with type 2 diabetes had more severe depressive symptoms, higher levels of emotional cutoff, and a lower tendency to take an I-position, but had similar levels of trait anxiety, emotional reactivity, and fusion with others (factor analysis revealed these factors were not separable in the current sample and thus were merged into a single construct). Importantly, the severity of depressive symptoms mediated the relationship between emotional cutoff and being in the type 2 diabetes study group rather than the healthy group. CONCLUSION These findings suggest a new perspective on the role of psychological patterns in type 2 diabetes mellitus development and progression.
Collapse
Affiliation(s)
- Ami Cohen
- Department of Psychology, The Max Stern Yezreel Valley College, Emek Yezreel, Israel.
| | - Ora Peleg
- Department of Counseling and Education, The Max Stern Yezreel Valley College, Emek Yezreel, Israel
| | - Amira Sarhana
- Department of Counseling and Education, The Max Stern Yezreel Valley College, Emek Yezreel, Israel
| | - Shany Lam
- Department of Counseling and Education, The Max Stern Yezreel Valley College, Emek Yezreel, Israel
| | - Iris Haimov
- Department of Psychology, The Max Stern Yezreel Valley College, Emek Yezreel, Israel
| |
Collapse
|
27
|
Richter B, Hemmingsen B, Metzendorf M, Takwoingi Y. Development of type 2 diabetes mellitus in people with intermediate hyperglycaemia. Cochrane Database Syst Rev 2018; 10:CD012661. [PMID: 30371961 PMCID: PMC6516891 DOI: 10.1002/14651858.cd012661.pub2] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Intermediate hyperglycaemia (IH) is characterised by one or more measurements of elevated blood glucose concentrations, such as impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and elevated glycosylated haemoglobin A1c (HbA1c). These levels are higher than normal but below the diagnostic threshold for type 2 diabetes mellitus (T2DM). The reduced threshold of 5.6 mmol/L (100 mg/dL) fasting plasma glucose (FPG) for defining IFG, introduced by the American Diabetes Association (ADA) in 2003, substantially increased the prevalence of IFG. Likewise, the lowering of the HbA1c threshold from 6.0% to 5.7% by the ADA in 2010 could potentially have significant medical, public health and socioeconomic impacts. OBJECTIVES To assess the overall prognosis of people with IH for developing T2DM, regression from IH to normoglycaemia and the difference in T2DM incidence in people with IH versus people with normoglycaemia. SEARCH METHODS We searched MEDLINE, Embase, ClincialTrials.gov and the International Clinical Trials Registry Platform (ICTRP) Search Portal up to December 2016 and updated the MEDLINE search in February 2018. We used several complementary search methods in addition to a Boolean search based on analytical text mining. SELECTION CRITERIA We included prospective cohort studies investigating the development of T2DM in people with IH. We used standard definitions of IH as described by the ADA or World Health Organization (WHO). We excluded intervention trials and studies on cohorts with additional comorbidities at baseline, studies with missing data on the transition from IH to T2DM, and studies where T2DM incidence was evaluated by documents or self-report only. DATA COLLECTION AND ANALYSIS One review author extracted study characteristics, and a second author checked the extracted data. We used a tailored version of the Quality In Prognosis Studies (QUIPS) tool for assessing risk of bias. We pooled incidence and incidence rate ratios (IRR) using a random-effects model to account for between-study heterogeneity. To meta-analyse incidence data, we used a method for pooling proportions. For hazard ratios (HR) and odds ratios (OR) of IH versus normoglycaemia, reported with 95% confidence intervals (CI), we obtained standard errors from these CIs and performed random-effects meta-analyses using the generic inverse-variance method. We used multivariable HRs and the model with the greatest number of covariates. We evaluated the certainty of the evidence with an adapted version of the GRADE framework. MAIN RESULTS We included 103 prospective cohort studies. The studies mainly defined IH by IFG5.6 (FPG mmol/L 5.6 to 6.9 mmol/L or 100 mg/dL to 125 mg/dL), IFG6.1 (FPG 6.1 mmol/L to 6.9 mmol/L or 110 mg/dL to 125 mg/dL), IGT (plasma glucose 7.8 mmol/L to 11.1 mmol/L or 140 mg/dL to 199 mg/dL two hours after a 75 g glucose load on the oral glucose tolerance test, combined IFG and IGT (IFG/IGT), and elevated HbA1c (HbA1c5.7: HbA1c 5.7% to 6.4% or 39 mmol/mol to 46 mmol/mol; HbA1c6.0: HbA1c 6.0% to 6.4% or 42 mmol/mol to 46 mmol/mol). The follow-up period ranged from 1 to 24 years. Ninety-three studies evaluated the overall prognosis of people with IH measured by cumulative T2DM incidence, and 52 studies evaluated glycaemic status as a prognostic factor for T2DM by comparing a cohort with IH to a cohort with normoglycaemia. Participants were of Australian, European or North American origin in 41 studies; Latin American in 7; Asian or Middle Eastern in 50; and Islanders or American Indians in 5. Six studies included children and/or adolescents.Cumulative incidence of T2DM associated with IFG5.6, IFG6.1, IGT and the combination of IFG/IGT increased with length of follow-up. Cumulative incidence was highest with IFG/IGT, followed by IGT, IFG6.1 and IFG5.6. Limited data showed a higher T2DM incidence associated with HbA1c6.0 compared to HbA1c5.7. We rated the evidence for overall prognosis as of moderate certainty because of imprecision (wide CIs in most studies). In the 47 studies reporting restitution of normoglycaemia, regression ranged from 33% to 59% within one to five years follow-up, and from 17% to 42% for 6 to 11 years of follow-up (moderate-certainty evidence).Studies evaluating the prognostic effect of IH versus normoglycaemia reported different effect measures (HRs, IRRs and ORs). Overall, the effect measures all indicated an elevated risk of T2DM at 1 to 24 years of follow-up. Taking into account the long-term follow-up of cohort studies, estimation of HRs for time-dependent events like T2DM incidence appeared most reliable. The pooled HR and the number of studies and participants for different IH definitions as compared to normoglycaemia were: IFG5.6: HR 4.32 (95% CI 2.61 to 7.12), 8 studies, 9017 participants; IFG6.1: HR 5.47 (95% CI 3.50 to 8.54), 9 studies, 2818 participants; IGT: HR 3.61 (95% CI 2.31 to 5.64), 5 studies, 4010 participants; IFG and IGT: HR 6.90 (95% CI 4.15 to 11.45), 5 studies, 1038 participants; HbA1c5.7: HR 5.55 (95% CI 2.77 to 11.12), 4 studies, 5223 participants; HbA1c6.0: HR 10.10 (95% CI 3.59 to 28.43), 6 studies, 4532 participants. In subgroup analyses, there was no clear pattern of differences between geographic regions. We downgraded the evidence for the prognostic effect of IH versus normoglycaemia to low-certainty evidence due to study limitations because many studies did not adequately adjust for confounders. Imprecision and inconsistency required further downgrading due to wide 95% CIs and wide 95% prediction intervals (sometimes ranging from negative to positive prognostic factor to outcome associations), respectively.This evidence is up to date as of 26 February 2018. AUTHORS' CONCLUSIONS Overall prognosis of people with IH worsened over time. T2DM cumulative incidence generally increased over the course of follow-up but varied with IH definition. Regression from IH to normoglycaemia decreased over time but was observed even after 11 years of follow-up. The risk of developing T2DM when comparing IH with normoglycaemia at baseline varied by IH definition. Taking into consideration the uncertainty of the available evidence, as well as the fluctuating stages of normoglycaemia, IH and T2DM, which may transition from one stage to another in both directions even after years of follow-up, practitioners should be careful about the potential implications of any active intervention for people 'diagnosed' with IH.
Collapse
Affiliation(s)
- Bernd Richter
- Institute of General Practice, Medical Faculty of the Heinrich‐Heine‐University DüsseldorfCochrane Metabolic and Endocrine Disorders GroupPO Box 101007DüsseldorfGermany40001
| | - Bianca Hemmingsen
- Institute of General Practice, Medical Faculty of the Heinrich‐Heine‐University DüsseldorfCochrane Metabolic and Endocrine Disorders GroupPO Box 101007DüsseldorfGermany40001
| | - Maria‐Inti Metzendorf
- Institute of General Practice, Medical Faculty of the Heinrich‐Heine‐University DüsseldorfCochrane Metabolic and Endocrine Disorders GroupPO Box 101007DüsseldorfGermany40001
| | - Yemisi Takwoingi
- University of BirminghamInstitute of Applied Health ResearchEdgbastonBirminghamUKB15 2TT
| | | |
Collapse
|
28
|
Deschênes SS, Burns RJ, Schmitz N. Comorbid depressive and anxiety symptoms and the risk of type 2 diabetes: Findings from the Lifelines Cohort Study. J Affect Disord 2018; 238:24-31. [PMID: 29852343 DOI: 10.1016/j.jad.2018.05.029] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 04/16/2018] [Accepted: 05/21/2018] [Indexed: 01/14/2023]
Abstract
BACKGROUND Prior studies indicate that depression is a risk factor for type 2 diabetes (T2D), though there is considerable heterogeneity in reported estimates. Identifying homogeneous subgroups of depression strongly associated with T2D may be beneficial. This study examined associations between depression and anxiety comorbidity with the risk of T2D. METHODS 78,025 participants from the Lifelines Cohort Study (age range = 30-75 years) without diabetes at baseline were included in this study. The Mini-International Neuropsychiatric Interview assessed depressive and anxiety symptoms at baseline. Incident T2D was assessed by self-report or hemoglobin A1c levels during an approximately 3.8-year follow-up period. Risk of T2D was compared across four groups (no depressive or anxiety symptoms, depressive symptoms alone, anxiety symptoms alone, comorbid depressive/anxiety symptoms) using mixed effects logistic regression analyses adjusted for sociodemographic, lifestyle, and cardiometabolic characteristics. RESULTS 1,096 participants developed diabetes. Compared to those without depressive or anxiety symptoms (n = 74,467), those with comorbid depressive and anxiety symptoms (n = 743) were more likely to develop T2D (n = 28, OR = 2.12, 95% CI = 1.22-3.68). Depressive symptoms alone (n = 650) and anxiety symptoms alone (n = 2,165) were not significantly associated with T2D (n = 23 and n = 24, respectively, developed diabetes). Those with comorbid symptoms were also more likely to develop T2D compared to those with depressive symptoms alone (OR = 2.86, 95% CI = 1.25-6.54). LIMITATIONS Depressive and anxiety symptom assessments were based on a screening tool. Hemoglobin A1c data were only available for a subset of participants. CONCLUSIONS Depression with comorbid anxiety may be a subgroup of depression that is strongly associated with the risk of T2D.
Collapse
Affiliation(s)
- Sonya S Deschênes
- Department of Psychiatry, McGill University, Montreal, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada.
| | - Rachel J Burns
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada
| | - Norbert Schmitz
- Department of Psychiatry, McGill University, Montreal, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada; Department of Epidemiology and Biostatistics, McGill University, Montreal, Canada
| |
Collapse
|
29
|
Munkhaugen J, Hjelmesæth J, Otterstad JE, Helseth R, Sollid ST, Gjertsen E, Gullestad L, Perk J, Moum T, Husebye E, Dammen T. Managing patients with prediabetes and type 2 diabetes after coronary events: individual tailoring needed - a cross-sectional study. BMC Cardiovasc Disord 2018; 18:160. [PMID: 30075751 PMCID: PMC6091110 DOI: 10.1186/s12872-018-0896-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Accepted: 07/24/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Understanding the determinants associated with prediabetes and type 2 diabetes in coronary patients may help to individualize treatment and modelling interventions. We sought to identify sociodemographic, medical and psychosocial factors associated with normal blood glucose (HbA1c < 5.7%), prediabetes (HbA1c 5.7-6.4%), and type 2 diabetes. METHODS A cross-sectional explorative study applied regression analyses to investigate the factors associated with glycaemic status and control (HbA1c level) in 1083 patients with myocardial infarction and/or a coronary revascularization procedure. Data were collected from hospital records at the index event and from a self-report questionnaire and clinical examination with blood samples at 2-36 months follow-up. RESULTS In all, 23% had type 2 diabetes, 44% had prediabetes, and 33% had normal blood glucose at follow-up. In adjusted analyses, type 2 diabetes was associated with larger waist circumference (Odds Ratio 1.03 per 1.0 cm, p = 0.001), hypertension (Odds Ratio 2.7, p < 0.001), lower high-density lipoprotein cholesterol (Odds Ratio 0.3 per1.0 mmol/L, p = 0.002) and insomnia (Odds Ratio 2.0, p = 0.002). In adjusted analyses, prediabetes was associated with smoking (Odds Ratio 3.3, p = 0.001), hypertension (Odds Ratio 1.5, p = 0.03), and non-participation in cardiac rehabilitation (Odds Ratio 1.7, p = 0.003). In patients with type 2 diabetes, a higher HbA1c level was associated with ethnic minority background (standardized beta [β] 0.19, p = 0.005) and low drug adherence (β 0.17, p = 0.01). In patients with prediabetes or normal blood glucose, a higher HbA1c was associated with larger waist circumference (β 0.13, p < 0.001), smoking (β 0.18, p < 0.001), hypertension (β 0.08, p = 0.04), older age (β 0.16, p < 0.001), and non-participation in cardiac rehabilitation (β 0.11, p = 0.005). CONCLUSIONS Along with obesity and hypertension, insomnia and low drug adherence were the major modifiable factors associated with type 2 diabetes, whereas smoking and non-participation in cardiac rehabilitation were the factors associated with prediabetes. Further research on the effect of individual tailoring, addressing the reported significant predictors of failure, is needed to improve glycaemic control. TRIAL REGISTRATION Retrospectively registered at ClinicalTrials.gov: NCT02309255 , December 5th 2014.
Collapse
Affiliation(s)
- John Munkhaugen
- Department of Medicine, Drammen Hospital, Vestre Viken Health Trust, Dronninggata 41, 3004, Drammen, Norway. .,Department of Behavioural Sciences in Medicine and Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Jøran Hjelmesæth
- Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Endocrinology, Morbid Obesity and Preventive Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - Ragnhild Helseth
- Centre for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Erik Gjertsen
- Department of Medicine, Drammen Hospital Trust, Drammen, Norway
| | - Lars Gullestad
- Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | | | - Torbjørn Moum
- Department of Behavioural Sciences in Medicine and Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Einar Husebye
- Department of Medicine, Drammen Hospital Trust, Drammen, Norway
| | - Toril Dammen
- Department of Behavioural Sciences in Medicine and Faculty of Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
30
|
Smith KJ, Deschênes SS, Schmitz N. Investigating the longitudinal association between diabetes and anxiety: a systematic review and meta-analysis. Diabet Med 2018; 35:677-693. [PMID: 29460506 PMCID: PMC5969311 DOI: 10.1111/dme.13606] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/16/2018] [Indexed: 12/17/2022]
Abstract
AIM Previous research has indicated an association between diabetes and anxiety. However, no synthesis has determined the direction of this association. The aim of this study was to determine the longitudinal relationship between anxiety and diabetes. METHODS We searched seven databases for studies examining the longitudinal relationship between anxiety and diabetes. Two independent reviewers screened studies from a population aged 16 or older that examined either anxiety as a risk factor for incident diabetes or diabetes as a risk factor for incident anxiety. Studies that met eligibility criteria were put forward for data extraction and meta-analysis. RESULTS In total 14 studies (n = 1 760 800) that examined anxiety as a risk factor for incident diabetes and two (n = 88 109) that examined diabetes as a risk factor for incident anxiety were eligible for inclusion in the review. Only studies examining anxiety as a risk factor for incident diabetes were put forward for the meta-analysis. The least adjusted (unadjusted or adjusted for age only) estimate indicated a significant association between baseline anxiety with incident diabetes (odds ratio 1.47, 1.23-1.75). Furthermore, most-adjusted analyses indicated a significant association between baseline anxiety and incident diabetes. Included studies that examined diabetes to incident anxiety found no association. CONCLUSIONS There was an association between baseline anxiety and incident diabetes. The results also indicate the need for more research to examine the direction of association from diabetes to incident anxiety. This work adds to the growing body of evidence that poor mental health increases the risk of developing diabetes.
Collapse
Affiliation(s)
- K. J. Smith
- Department of Psychological SciencesUniversity of SurreyGuildfordUK
| | - S. S. Deschênes
- Douglas Mental Health University InstituteMontrealCanada
- Department of PsychiatryMcGill UniversityMontrealCanada
| | - N. Schmitz
- Douglas Mental Health University InstituteMontrealCanada
- Department of PsychiatryMcGill UniversityMontrealCanada
- Department of Epidemiology and BiostatisticsMcGill UniversityMontrealCanada
- Montreal Diabetes Research CenterMontrealCanada
| |
Collapse
|
31
|
Rawlings AM, Sharrett AR, Golden SH, Windham BG, Selvin E. Prevalence and correlates of depressive symptoms in older adults across the glycaemic spectrum: the Atherosclerosis Risk in Communities (ARIC) study. Diabet Med 2018; 35:583-587. [PMID: 29384594 PMCID: PMC5902432 DOI: 10.1111/dme.13593] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/25/2018] [Indexed: 01/26/2023]
Abstract
AIMS To document the prevalence of current depressive symptoms and history of depression across the glycaemic spectrum in older adults, and examine if measures of health status and healthcare satisfaction, access and utilization explain differences in the prevalence of current depressive symptoms by diabetes status. METHODS We conducted a cross-sectional study of 6226 participants aged 67-90 years who attended the 2011-2013 visit of the Atherosclerosis Risk in Communities (ARIC) study. Diabetes was based on self-report, medication use and HbA1c . Current depressive symptoms were defined using the Center for Epidemiologic Studies Depression 11-item questionnaire, and history of depression was assessed via self-report. We examined obesity, history of cardiovascular disease, hypertension, kidney disease, cognitive function, and self-reported health compared with others. Prevalence and prevalence ratios were estimated using age-, race-, and sex-adjusted Poisson regression. RESULTS The prevalence of current depressive symptoms was 5.4% in people without diabetes and 11.0% in people with diabetes (prevalence ratio 2.04, 95% CI 1.60, 2.48); the prevalence of history of depression was 11% in people without diabetes and 17.7% in people with diabetes (prevalence ratio 1.61, 95% CI 1.28,1.95). Strong correlates of current depressive symptoms were history of depression (prevalence ratio 3.86, 95% CI 3.05, 4.90) and reporting poor health compared with others (prevalence ratio 3.88, 95% CI 2.93, 5.15). No variables had significantly different associations with depressive symptoms across glycaemic categories (P for interaction >0.10). CONCLUSIONS In older adults, current depressive symptoms were twice as prevalent in people with diabetes compared with those without. Measures of health status and healthcare did not explain differences in depressive symptoms between people with and without diabetes.
Collapse
Affiliation(s)
- A M Rawlings
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR
| | - A R Sharrett
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - S H Golden
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Department of Medicine, Johns Hopkins University, Baltimore, MD
| | - B G Windham
- Department of Medicine, Division of Geriatrics, University of Mississippi Medical Center, Jackson, MI, USA
| | - E Selvin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| |
Collapse
|
32
|
Zhuang QS, Shen L, Ji HF. Quantitative assessment of the bidirectional relationships between diabetes and depression. Oncotarget 2017; 8:23389-23400. [PMID: 28177893 PMCID: PMC5410312 DOI: 10.18632/oncotarget.15051] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 01/09/2017] [Indexed: 01/07/2023] Open
Abstract
Diabetes and depression impose an enormous public health burden and the present study aimed to assess quantitatively the bidirectional relationships between the two disorders. We searched databases for eligible articles published until October 2016. A total of 51 studies were finally included in the present bidirectional meta-analysis, among which, 32 studies were about the direction of depression leading to diabetes, and 24 studies about the direction of diabetes leading to depression. Pooled results of the 32 eligible studies covering 1274337 subjects showed that depression patients were at higher risk for diabetes (odds ratio (OR) = 1.34, 95% confidence intervals (CI) = [1.23, 1.46]) than non-depressive subjects. Further gender-subgroup analysis found that the strength of this relationship was stronger in men (OR = 1.63, 95%CI = [1.48, 1.78]) than in women (OR = 1.29, 95%CI = [1.07, 1.51]). For the direction of diabetes leading to depression, pooled data of 24 articles containing 329658 subjects showed that patients with diabetes were at higher risk for diabetes (OR = 1.28, 95%CI = [1.15, 1.42]) than non-diabetic subjects. The available data supports that the relationships between diabetes and depression are bidirectional and the overall strengths are similar in both directions. More mechanistic studies are encouraged to explore the molecular mechanisms underlying the relationships between the two diseases.
Collapse
Affiliation(s)
- Qi-Shuai Zhuang
- Shandong Provincial Research Center for Bioinformatic Engineering and Technique, School of Life Sciences, Shandong University of Technology, Zibo, P. R. China
| | - Liang Shen
- Shandong Provincial Research Center for Bioinformatic Engineering and Technique, School of Life Sciences, Shandong University of Technology, Zibo, P. R. China
| | - Hong-Fang Ji
- Shandong Provincial Research Center for Bioinformatic Engineering and Technique, School of Life Sciences, Shandong University of Technology, Zibo, P. R. China
| |
Collapse
|
33
|
Deschênes SS, Burns RJ, Schmitz N. Response to Kawada: Anxiety symptoms and functioning in patients with type 2 diabetes. J Diabetes 2017; 9:635-636. [PMID: 28150438 DOI: 10.1111/1753-0407.12534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 01/27/2017] [Indexed: 11/29/2022] Open
Affiliation(s)
- Sonya S Deschênes
- Department of Psychiatry, McGill University, Montreal, Canada
- Douglas Mental Health University Institute, Montreal, Canada
| | - Rachel J Burns
- Department of Psychiatry, McGill University, Montreal, Canada
- Douglas Mental Health University Institute, Montreal, Canada
| | - Norbert Schmitz
- Department of Psychiatry, McGill University, Montreal, Canada
- Department of Epidemiology and Biostatistics, McGill University, Montreal, Canada
- Douglas Mental Health University Institute, Montreal, Canada
| |
Collapse
|
34
|
Kawada T. Anxiety symptoms and functioning in patients with type 2 diabetes. J Diabetes 2017; 9:634. [PMID: 28097827 DOI: 10.1111/1753-0407.12530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 01/11/2017] [Indexed: 11/28/2022] Open
Affiliation(s)
- Tomoyuki Kawada
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan
| |
Collapse
|