Diabetes, depression and death risk

Older women who suffer from both diabetes and depression are at a higher risk of dying from all causes, including heart disease.

Symptoms of depression affect between one-fifth and one-fourth of patients with diabetes, nearly twice as many as individuals without diabetes. Diabetes and its complications are leading causes of death around the world.

To evaluate the effects of depression and diabetes on all-cause and cardiovascular mortality rate, researchers from Boston looked at 78,282 women aged between 54 and 79 years in 2000 who were participating in the Nurses' Health Study. The women in the study were confirmed to be type II diabetes via questionnaires. They were classified as having depression if they reported being diagnosed with the condition, were treated with antidepressants or scored high on an index measuring depressive symptoms.

During the six-year follow up, the researchers found a 44 per cent higher risk of dying from cardiovascular among women with depression and a 35 per cent higher death risk among women with diabetes, compared to those who had neither. For cardiovascular disease alone, women with diabetes had a 67 per cent higher risk of death, women with depression had a 37 per cent higher risk and women with both had a 2.7-fold increased risk.

The researchers speculated that depression leads to poor glycemic control, failure to control diabetes that leads to complications and isolation from social network. Diabetes and depression are both linked to unhealthy behaviours such as poor diet, smoking and a sedentary lifestyle, they added. They also speculate that depression might be linked to higher death rates in women because of changes in the nervous system that affect the heart. Considering the number of individuals that could be affected by these two prevalent disorders, they recommend strategies aimed to provide adequate psychological management and support to such patients.