Depression found to increase risk of death among diabetics

In a newly published study, a New Mexico State University researcher found that depression can cause premature death among adults in the United States diagnosed with diabetes.

Jagdish Khubchandani, a professor of public health sciences at NMSU, conducted the study with Srikanta Banerjee of Walden University to understand the long-term impacts of depression in American adults living with Type 2 diabetes—an area they said lacked research.

"More than 35 million Americans have diabetes, and more than 95 million have prediabetes, making diabetes one of the leading causes of death in the U.S.," Khubchandani said. "Unfortunately, a large proportion of these people struggle with depression, anxiety, or poor mental health."

To complete the study, Khubchandani and Banerjee analyzed data from the 2005-2010 National Health and Nutrition Examination Survey, a program of studies administered by the National Center for Health Statistics that assesses the health and nutritional status of adults and children in the U.S. They then linked the data to death records from the Centers for Disease Control and Prevention. The study included 14,920 participants.

Their findings, published this month in Diabetes & Metabolic Syndrome: Clinical Research & Reviews, show that more than 10% of American adults suffer from depression or diabetes.

Overall, participants with diabetes were 1.7 times more likely to die prematurely than those without diabetes. However, the risk of death more than quadrupled for participants with both diabetes and depression compared to those without diabetes or depression.

"Diabetes alone is a debilitating disease, and the co-occurrence of depression makes it worse," Khubchandani said. "Unfortunately, many Americans with diabetes continue to struggle financially and emotionally, making it difficult to manage the disease."

The researchers wrote in the study that many demographic, psychosocial and biological mechanisms could be responsible for the co-occurrence of depression and diabetes, resulting in a higher risk of mortality among such individuals. These factors include poorer cognition and inadequate disease management, genetic and lifestyle risk factors, higher probability of occurrence of other diseases, greater financial burden and lower health care access, immune and vascular dysfunction, and stress that leads to worsening of depression and diabetes.

In many developed countries such as the U.S., the study notes, more than 75% of people with diabetes receive some type of treatment to manage their disorder. However, according to the study, more than 50% of diabetics with behavioral health issues do not get adequate mental health care.

Khubchandani said certain characteristics are common among individuals at higher risk for co-occurring depression and diabetes, including lower income and education, racial/ethnic minority status, unhealthy lifestyles, and having other chronic diseases. These populations, he added, should be considered high-risk groups by clinicians to prevent premature mortality among these groups.

The study suggests that clinicians should be sensitized to the psychosocial needs of people living with diabetes. It recommends integrating appropriate measures for treatment of mental health issues into primary and specialist care for diabetics.

"Improving the quality care for diabetes and co-occurring mental health issues could improve the well-being and life expectancy for Americans living with diabetes," Khubchandani said.