Comorbid stress, depressive symptoms common in diabetes

(HealthDay)—For individuals with diabetes, comorbid stress and/or depressive symptoms are common and increase risks for adverse cardiovascular (CV) outcomes, according to a study published online Nov. 17 in Diabetes Care.

Doyle M. Cummings, Pharm.D., from East Carolina University in Greenville, N.C., and colleagues examined the correlation between baseline depressive symptoms and/or stress in adults with and without diabetes and physician-adjudicated incident CV outcome. Data were included for 22,003 adults (4,090 with diabetes) who were followed for a median of 5.95 years.

The researchers found that subjects with diabetes more often had elevated stress and/or depressive symptoms (36.8 versus 29.5 percent; P < 0.001). Reporting either elevated stress or depressive symptoms correlated with a significantly increased incidence of stroke and CV death (hazard ratio, 1.57 and 1.53, respectively) in subjects with diabetes, but not in those without diabetes, in fully adjusted models. In subjects with diabetes, the combination of both elevated stress and depressive symptoms correlated with a higher incidence of CV death (hazard ratio, 2.15) than either behavioral comorbidity alone (hazard ratio, 1.53). The incidence of CV death was higher with both elevated stress and depressive symptoms in those with versus those without diabetes.

"These findings demonstrate the persistent disparities and negative CV impact of these comorbidities at the population level and suggest the need for more careful integration of behavioral screening and management in primary care settings," the authors write.

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