Depressed Diabetics Have Higher Mortality Risk

NEW YORK (Reuters Health) - Both minor and major depression are strongly associated with increased mortality in diabetic patients, according to results of a study published in the current issue of Diabetes Care.

Researchers in Seattle examined whether patients with minor or major depression and type 2 diabetes have a higher mortality rate compared with patients with diabetes alone. They surveyed 4,154 diabetic patients in a large health maintenance organization and followed them for up to 3 years.

The patients completed written questionnaires on sociodemographic characteristics, diabetes characteristics, and type and duration, and symptoms of depression. The investigators collected HMO-automated diagnostic, laboratory, and pharmacy data, and Washington State mortality rates to assess diabetes complications and deaths.

During the 3-year follow-up, there were 275 (8.3 percent) deaths in the 3,303 patients without depression. Among the 354 patients with minor depression, 48 (13.6 percent) died. Among the 497 patients with major depression, 59 (11.9 percent) died.

Compared with the nondepressed group, minor depression was associated with a 1.67-fold increase in mortality. Major depression was associated with a 2.30-fold increased risk compared to the nondepressed group.

"Screening and treatment of depression in patients with diabetes is very important," lead author Dr. Wayne J. Katon, of the University of Washington School of Medicine, told Reuters Health. "Our group and others have shown depression can be effectively treated in patients with diabetes."

"We are hoping to get funded to do a study testing an intervention by a nurse case manager aimed at improving quality of care for both depression and diabetes," Katon noted. "We have already shown that just effectively treating depression is associated -- compared to usual primary care in patients with diabetes and depression -- with not only improvements in depression but a high probability of medical cost savings."

"We have also found that depression decreases adherence to diet, exercise, and disease control medications in patients with diabetes," the author noted.

SOURCE: Diabetes Care, November 2005.