Type 1 Diabetics Have Higher Depression Rates

Adults with type 1 diabetes report more symptoms of depression and more often use anti-depressant medication than adults without type 1 diabetes, according to data released here at the 69th Scientific Sessions of the American Diabetes Association (ADA).

Different from type 2 diabetes, type 1 diabetes is diagnosed in children or in young adults and has a completely different mode of action. Type 1 diabetes, also referred to as insulin-dependent diabetes or juvenile diabetes, occurs when the pancreas does not produce enough insulin to control blood sugar levels. Eventually, the insulin-producing beta cells of the pancreas are completely destroyed and the body longer produces any insulin.

Dr. David Maahs, with the University of Colorado Health Science Center in Denver, and colleagues assessed the prevalence of depression and antidepressant medication use in 458 adults with type 1 diabetes and 546 adults without diabetes.

All of the subjects were enrolled in the CACTI (Coronary Artery Calcification in Type 1 Diabetes) study, which examined factors related to insulin resistance and calcification of the coronary arteries - a sign of heart disease — in type 1 diabetics without symptoms.

In the present analysis, depression was confirmed by a score of greater than 14 on the Beck Depression Inventory II (BDI-II) or by self-reports of current antidepressant use. Diabetes complications were also self-reported and included retinopathy, blindness, neuropathy, diabetes-related amputation, and kidney or pancreas transplantation.

The results showed that adults with type 1 diabetes were more than twice as likely as those without diabetes to have depression and almost three times as likely to have a clinically significant score on the BDI-II. Adult type 1 patients were also nearly twice as likely to be on antidepressant medications as nondiabetics (20.7 percent vs. 12.1 percent).

Overall, the prevalence of depression indicators in type 1 diabetics was 32.1 percent, compared with 16.0 percent in nondiabetics.

The study also found an association between depression and complications of diabetes. Type 1 diabetics who reported at least one diabetes complication had significantly higher scores on the BDI-II than type 1 diabetics without any complications (10.7 vs. 6.4).

Untreated depression tends to become chronic or lead to relapses, the investigators noted in their poster presentation, and physicians should aim to rigorously screen type 1 diabetic patients for depression. In particular, screening should target patients with complications of diabetes since they are more likely to have depressive symptoms, Maahs and his associates recommend.