Patients suffering type 2 diabetes and are at risk of advanced macrovascular and microvascular complications could be vulnerable to major depression too.
Advanced microvascular complications included blindness, end-stage renal disease, amputations, and renal failure deaths. Advanced macrovascular complications included myocardial infarction, stroke, cardiovascular procedures, and deaths.
A longitudinal cohort of 4,623 primary care patients with type 2 diabetes in the US was enrolled in 2000-2002 and followed through 2005-2007. Medical record review, ICD-9 diagnostic and procedural codes, and death certificate data were used to ascertain outcomes in the 5-year follow-up. Proportional hazard models analyzed the association between baseline depression and risks of adverse outcomes.
After adjustment for prior complications and demographic, clinical, and diabetes self-care variables, major depression was associated with significantly higher risks of adverse microvascular outcomes and adverse macrovascular outcomes.
The researchers led by Elizabeth H.B. Lin with the Group Health Cooperative, Washington, concluded, "
Among people with type 2 diabetes, major depression is associated with an increased risk of clinically significant microvascular and macrovascular complications over the ensuing 5 years, even after adjusting for diabetes severity and self-care activities. Clinical and public health significance of these findings rises as the incidence of type 2 diabetes soars. Further research is needed to clarify the underlying mechanisms for this association and to test interventions to reduce the risk of diabetes complications among patients with comorbid depression."