Skip to main content
SpringerLink
Log in

Diabetes, Depression, and Cardiovascular Risk

  • Reference work entry
  • First Online:
Handbook of Psychocardiology

  • 1972 Accesses

Abstract

Diabetes and depression are major public issues that often co-occur. Both diseases affect a growing number of people worldwide and are projected to be among the five leading causes of disease burden in 2030. Approximately 10–30 % of the people with type 1 (5–10 % of all diabetes cases) or type 2 diabetes is affected by depression. There is ample evidence that the association between type 2 diabetes and depression is bidirectional. Depression is likely to increase the risk of cardiovascular complications and mortality in people with diabetes. Several behavioral mechanisms (e.g., treatment nonadherence, physical inactivity, and poor diet) and biological mechanisms (e.g., deregulation of the hypothalamic–pituitary–adrenal axis and the sympathetic nervous system, vascular pathology, and central obesity) explain the link between depression and cardiovascular risk in diabetes patients. It has been postulated that treatment of depression could improve cardiovascular outcomes. Due to limited number of studies, there is currently no convincing evidence that pharmacological or psychological treatment of depression improves cardiovascular outcomes. Various organizations suggest screening for depression in their guidelines or recommendations for diabetes care. At present, there is no substantial evidence of the effectiveness of screening for depression among diabetes patients and is therefore not recommended. Future trials should focus on (a) the development of innovative interventions that can help to prevent depression, type 2 diabetes, and cardiovascular diseases in a cost-effective way and (b) long-term prospective studies that disentangle the mechanisms that link depression with unfavorable cardiovascular risks in diabetes patients.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 599.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 799.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Alexopoulos, G. S. (2006). The vascular depression hypothesis: 10 years later. Biological Psychiatry, 60(12), 1304–1305.

    Article  PubMed  Google Scholar 

  • Ali, S., Stone, M. A., Peters, J. L., Davies, M. J., & Khunti, K. (2006). The prevalence of co-morbid depression in adults with type 2 diabetes: A systematic review and meta-analysis. Diabetic Medicine, 23(11), 1165–1173.

    Article  PubMed  Google Scholar 

  • Ali, S., Stone, M., Skinner, T. C., Robertson, N., Davies, M., & Khunti, K. (2010). The association between depression and health-related quality of life in people with type 2 diabetes: A systematic literature review. Diabetes/Metabolism Research and Reviews, 26(2), 75–89.

    Article  PubMed  Google Scholar 

  • American Diabetes Association. (2013). Standards of medical care in diabetes – 2013. Diabetes Care, 36(Suppl 1), S11–S66.

    Article  PubMed Central  Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Publishing. Text revision.

    Google Scholar 

  • Barnard, K. D., Skinner, T. C., & Peveler, R. (2006). The prevalence of co-morbid depression in adults with type 1 diabetes: Systematic literature review. Diabetic Medicine, 23(4), 445–448.

    Article  PubMed  Google Scholar 

  • Barone, M. T., & Menna-Barreto, L. (2011). Diabetes and sleep: A complex cause-and-effect relationship. Diabetes Research and Clinical Practice, 91(2), 129–137.

    Article  PubMed  Google Scholar 

  • Baumeister, H., Hutter, N., & Bengel, J. (2012). Psychological and pharmacological interventions for depression in patients with diabetes mellitus and depression. Cochrane Database of Systematic Reviews, 12, CD008381.

    PubMed  Google Scholar 

  • Berkman, L. F., Blumenthal, J., Burg, M., et al. (2003). Effects of treating depression and low perceived social support on clinical events after myocardial infarction: The Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) Randomized Trial. JAMA, 289(23), 3106–3116.

    Article  PubMed  Google Scholar 

  • Bluestone, J. A., Herold, K., & Eisenbarth, G. (2010). Genetics, pathogenesis and clinical interventions in type 1 diabetes. Nature, 464(7293), 1293–1300.

    Article  PubMed  Google Scholar 

  • Bosmans, J. E., & Adriaanse, M. C. (2012). Outpatient costs in pharmaceutically treated diabetes patients with and without a diagnosis of depression in a Dutch primary care setting. BMC Health Services Research, 12, 46.

    Article  PubMed  PubMed Central  Google Scholar 

  • Buijsse, B., Simmons, R. K., Griffin, S. J., & Schulze, M. B. (2011). Risk assessment tools for identifying individuals at risk of developing type 2 diabetes. Epidemiologic Reviews, 33(1), 46–62.

    Article  PubMed  PubMed Central  Google Scholar 

  • Canadian Diabetes Association Clinical Practice Guidelines Expert C, Ekoe, J. M., Punthakee, Z., Ransom, T., Prebtani, A. P., & Goldenberg, R. (2013). Screening for type 1 and type 2 diabetes. Canadian Journal of Diabetes, 37(Suppl 1), S12–S15.

    Google Scholar 

  • Chen, P. C., Chan, Y. T., Chen, H. F., Ko, M. C., & Li, C. Y. (2013). Population-based cohort analyses of the bidirectional relationship between type 2 diabetes and depression. Diabetes Care, 36(2), 376–382.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cooney, G. M., Dwan, K., Greig, C. A., et al. (2013). Exercise for depression. Cochrane Database of Systematic Reviews, 9, CD004366.

    PubMed  Google Scholar 

  • Danaei, G., Finucane, M. M., Lu, Y., et al. (2011). National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: Systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants. Lancet, 378(9785), 31–40.

    Article  PubMed  Google Scholar 

  • de Groot, M., Anderson, R., Freedland, K. E., Clouse, R. E., & Lustman, P. J. (2001). Association of depression and diabetes complications: A meta-analysis. Psychosomatic Medicine, 63(4), 619–630.

    Article  PubMed  Google Scholar 

  • de Jonge, P., Rosmalen, J. G., Kema, I. P., et al. (2010). Psychophysiological biomarkers explaining the association between depression and prognosis in coronary artery patients: A critical review of the literature. Neuroscience and Biobehavioral Reviews, 35(1), 84–90.

    Article  PubMed  Google Scholar 

  • Donath, M. Y., & Shoelson, S. E. (2011). Type 2 diabetes as an inflammatory disease. Nature Reviews. Immunology, 11(2), 98–107.

    Article  PubMed  Google Scholar 

  • Dowlati, Y., Herrmann, N., Swardfager, W., et al. (2010). A meta-analysis of cytokines in major depression. Biological Psychiatry, 67(5), 446–457.

    Article  PubMed  Google Scholar 

  • Dugan, S. A., Bromberger, J. T., Segawa, E., Avery, E., & Sternfeld, B. (2015). Association between physical activity and depressive symptoms: midlife women in SWAN. Medicine and science in sports and exercise, 47(2), 335–342.

    Google Scholar 

  • Fabricatore, A. N., Wadden, T. A., Higginbotham, A. J., et al. (2011). Intentional weight loss and changes in symptoms of depression: A systematic review and meta-analysis. International Journal of Obesity, 35(11), 1363–1376.

    Article  PubMed  PubMed Central  Google Scholar 

  • Frasure-Smith, N., Lesperance, F., Irwin, M. R., Talajic, M., & Pollock, B. G. (2009). The relationships among heart rate variability, inflammatory markers and depression in coronary heart disease patients. Brain, Behavior, and Immunity, 23(8), 1140–1147.

    Article  PubMed  Google Scholar 

  • Gendelman, N., Snell-Bergeon, J. K., McFann, K., et al. (2009). Prevalence and correlates of depression in individuals with and without type 1 diabetes. Diabetes Care, 32(4), 575–579.

    Article  PubMed  PubMed Central  Google Scholar 

  • Gilbody, S., Sheldon, T., & House, A. (2008). Screening and case-finding instruments for depression: A meta-analysis. CMAJ, 178(8), 997–1003.

    Article  PubMed  PubMed Central  Google Scholar 

  • Golden, S. H. (2007). A review of the evidence for a neuroendocrine link between stress, depression and diabetes mellitus. Current Diabetes Reviews, 3(4), 252–259.

    Article  PubMed  Google Scholar 

  • Golden, S. H., Lazo, M., Carnethon, M., et al. (2008). Examining a bidirectional association between depressive symptoms and diabetes. JAMA, 299(23), 2751–2759.

    Article  PubMed  PubMed Central  Google Scholar 

  • Gonzalez, J. S., Peyrot, M., McCarl, L. A., et al. (2008). Depression and diabetes treatment nonadherence: A meta-analysis. Diabetes Care, 31(12), 2398–2403.

    Article  PubMed  PubMed Central  Google Scholar 

  • Handelsman, Y., Mechanick, J. I., Blonde, L., et al. (2011). American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for developing a diabetes mellitus comprehensive care plan. Endocrine Practice, 17(Suppl 2), 1–53.

    Article  PubMed  Google Scholar 

  • Hood, K. K., Lawrence, J. M., Anderson, A., et al. (2012). Metabolic and inflammatory links to depression in youth with diabetes. Diabetes Care, 35(12), 2443–2446.

    Article  PubMed  PubMed Central  Google Scholar 

  • Huang, Y., Wei, X., Wu, T., Chen, R., & Guo, A. (2013). Collaborative care for patients with depression and diabetes mellitus: A systematic review and meta-analysis. BMC Psychiatry, 13, 260.

    Article  PubMed  PubMed Central  Google Scholar 

  • IDF Clinical Guidelines Task Force. (2012). Global guideline for type 2 diabetes. Brussels: International Diabetes Federation.

    Google Scholar 

  • International Diabetes Federation. (2013). IDF diabetes atlas (6th ed.). Brussels: International Diabetes Federation.

    Google Scholar 

  • Johnson, B., Eiser, C., Young, V., Brierley, S., & Heller, S. (2013). Prevalence of depression among young people with type 1 diabetes: A systematic review. Diabetic Medicine, 30(2), 199–208.

    Article  PubMed  Google Scholar 

  • Katon, W., Russo, J., Lin, E. H., et al. (2009). Depression and diabetes: Factors associated with major depression at five-year follow-up. Psychosomatics, 50(6), 570–579.

    Article  PubMed  PubMed Central  Google Scholar 

  • Katon, W. J., Lin, E. H., Von Korff, M., et al. (2010). Collaborative care for patients with depression and chronic illnesses. New England Journal of Medicine, 363(27), 2611–2620.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 593–602.

    Article  PubMed  Google Scholar 

  • Knol, M. J., Twisk, J. W., Beekman, A. T., Heine, R. J., Snoek, F. J., & Pouwer, F. (2006). Depression as a risk factor for the onset of type 2 diabetes mellitus. A meta-analysis. Diabetologia, 49(5), 837–845.

    Article  PubMed  Google Scholar 

  • Knutson, K. L., Ryden, A. M., Mander, B. A., & Van Cauter, E. (2006). Role of sleep duration and quality in the risk and severity of type 2 diabetes mellitus. Archives of Internal Medicine, 166(16), 1768–1774.

    Article  PubMed  Google Scholar 

  • Koopmans, B., Pouwer, F., de Bie, R. A., van Rooij, E. S., Leusink, G. L., & Pop, V. J. (2009). Depressive symptoms are associated with physical inactivity in patients with type 2 diabetes. The DIAZOB Primary Care Diabetes study. Family Practice, 26(3), 171–173.

    Article  PubMed  Google Scholar 

  • Krishnan, V., & Nestler, E. J. (2008). The molecular neurobiology of depression. Nature, 455(7215), 894–902.

    Article  PubMed  PubMed Central  Google Scholar 

  • Labad, J., Price, J. F., Strachan, M. W., et al. (2010). Symptoms of depression but not anxiety are associated with central obesity and cardiovascular disease in people with type 2 diabetes: The Edinburgh type 2 diabetes study. Diabetologia, 53(3), 467–471.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lin, E. H., Katon, W., Von Korff, M., et al. (2004). Relationship of depression and diabetes self-care, medication adherence, and preventive care. Diabetes Care, 27(9), 2154–2160.

    Article  PubMed  Google Scholar 

  • Lin, E. H., Rutter, C. M., Katon, W., et al. (2010). Depression and advanced complications of diabetes: A prospective cohort study. Diabetes Care, 33(2), 264–269.

    Article  PubMed  PubMed Central  Google Scholar 

  • Look Ahead Research Group, & Wing, R. R. (2010). Long-term effects of a lifestyle intervention on weight and cardiovascular risk factors in individuals with type 2 diabetes mellitus: Four-year results of the look AHEAD trial. Archives of Internal Medicine, 170(17), 1566–1575.

    Google Scholar 

  • Luppino, F. S., de Wit, L. M., Bouvy, P. F., et al. (2010). Overweight, obesity, and depression: A systematic review and meta-analysis of longitudinal studies. Archives of General Psychiatry, 67(3), 220–229.

    Article  PubMed  Google Scholar 

  • Lustman, P. J., & Clouse, R. E. (2005). Depression in diabetic patients: The relationship between mood and glycemic control. Journal of Diabetes and its Complications, 19(2), 113–122.

    PubMed  Google Scholar 

  • Lustman, P. J., Anderson, R. J., Freedland, K. E., de Groot, M., Carney, R. M., & Clouse, R. E. (2000). Depression and poor glycemic control: A meta-analytic review of the literature. Diabetes Care, 23(7), 934–942.

    Article  PubMed  Google Scholar 

  • Mammen, G., & Faulkner, G. (2013). Physical activity and the prevention of depression: A systematic review of prospective studies. American Journal of Preventive Medicine, 45(5), 649–657.

    Article  PubMed  Google Scholar 

  • Marshall, S. M., & Flyvbjerg, A. (2006). Prevention and early detection of vascular complications of diabetes. BMJ, 333(7566), 475–480.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mathers, C. D., & Loncar, D. (2006). Projections of global mortality and burden of disease from 2002 to 2030. PLoS Medicine, 3(11), e442.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mezuk, B., Eaton, W. W., Albrecht, S., & Golden, S. H. (2008). Depression and type 2 diabetes over the lifespan: A meta-analysis. Diabetes Care, 31(12), 2383–2390.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mommersteeg, P. M., Herr, R., Pouwer, F., Holt, R. I., & Loerbroks, A. (2013). The association between diabetes and an episode of depressive symptoms in the 2002 World Health Survey: An analysis of 231,797 individuals from 47 countries. Diabetic Medicine, 30(6), e208–e214.

    Article  PubMed  Google Scholar 

  • Moussavi, S., Chatterji, S., Verdes, E., Tandon, A., Patel, V., & Ustun, B. (2007). Depression, chronic diseases, and decrements in health: Results from the world health surveys. Lancet, 370(9590), 851–858.

    Article  PubMed  Google Scholar 

  • Nouwen, A., Winkley, K., Twisk, J., et al. (2010). Type 2 diabetes mellitus as a risk factor for the onset of depression: A systematic review and meta-analysis. Diabetologia, 53(12), 2480–2486.

    Article  PubMed  PubMed Central  Google Scholar 

  • Nouwen, A., Nefs, G., Caramlau, I., et al. (2011). Prevalence of depression in individuals with impaired glucose metabolism or undiagnosed diabetes: A systematic review and meta-analysis of the European depression in diabetes (EDID) research consortium. Diabetes Care, 34(3), 752–762.

    Article  PubMed  PubMed Central  Google Scholar 

  • Pan, A., Lucas, M., Sun, Q., et al. (2010). Bidirectional association between depression and type 2 diabetes mellitus in women. Archives of Internal Medicine, 170(21), 1884–1891.

    Article  PubMed  PubMed Central  Google Scholar 

  • Pouwer, F., Tack, C. J., Geelhoed-Duijvestijn, P. H., et al. (2011). Limited effect of screening for depression with written feedback in outpatients with diabetes mellitus: A randomised controlled trial. Diabetologia, 54(4), 741–748.

    Article  PubMed  PubMed Central  Google Scholar 

  • Renn, B. N., Feliciano, L., & Segal, D. L. (2011). The bidirectional relationship of depression and diabetes: A systematic review. Clinical Psychology Review, 31(8), 1239–1246.

    Article  PubMed  Google Scholar 

  • Rosmond, R., & Bjorntorp, P. (2000). The hypothalamic-pituitary-adrenal axis activity as a predictor of cardiovascular disease, type 2 diabetes and stroke. Journal of Internal Medicine, 247(2), 188–197.

    Article  PubMed  Google Scholar 

  • Rotella, F., & Mannucci, E. (2013). Diabetes mellitus as a risk factor for depression. A meta-analysis of longitudinal studies. Diabetes Research and Clinical Practice, 99(2), 98–104.

    Article  PubMed  Google Scholar 

  • Roy, T., & Lloyd, C. E. (2012). Epidemiology of depression and diabetes: A systematic review. Journal of Affective Disorders, 142(Suppl), S8–S21.

    Article  PubMed  Google Scholar 

  • Scherrer, J. F., Garfield, L. D., Chrusciel, T., et al. (2011). Increased risk of myocardial infarction in depressed patients with type 2 diabetes. Diabetes Care, 34(8), 1729–1734.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sontrop, J., & Campbell, M. K. (2006). Omega-3 polyunsaturated fatty acids and depression: A review of the evidence and a methodological critique. Preventive Medicine, 42(1), 4–13.

    Article  PubMed  Google Scholar 

  • Strine, T. W., Mokdad, A. H., Balluz, L. S., et al. (2008). Depression and anxiety in the United States: Findings from the 2006 behavioral risk factor surveillance system. Psychiatric Services, 59(12), 1383–1390.

    Article  PubMed  Google Scholar 

  • Sullivan, M. D., O’Connor, P., Feeney, P., et al. (2012). Depression predicts all-cause mortality: Epidemiological evaluation from the ACCORD HRQL substudy. Diabetes Care, 35(8), 1708–1715.

    Article  PubMed  PubMed Central  Google Scholar 

  • Tabak, A. G., Akbaraly, T. N., Batty, G. D., & Kivimaki, M. (2014). Depression and type 2 diabetes: A causal association? The Lancet Diabetes & Endocrinology, 2(3), 236–245.

    Article  Google Scholar 

  • Thombs, B. D., & Ziegelstein, R. C. (2008). Diabetes, depression, and death: A randomized controlled trial of a depression treatment program for older adults based in primary care (PROSPECT): Response to Bogner et al. Diabetes Care, 31(6), e54; author reply e55.

    Article  PubMed  Google Scholar 

  • Thombs, B. D., de Jonge, P., Coyne, J. C., et al. (2008). Depression screening and patient outcomes in cardiovascular care: A systematic review. JAMA, 300(18), 2161–2171.

    Article  PubMed  Google Scholar 

  • Thombs, B. D., Coyne, J. C., Cuijpers, P., et al. (2012). Rethinking recommendations for screening for depression in primary care. CMAJ, 184(4), 413–418.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ting, R. Z., Lau, E. S., Ozaki, R., et al. (2013). High risk for cardiovascular disease in Chinese type 2 diabetic patients with major depression – A 7-year prospective analysis of the Hong Kong Diabetes Registry. Journal of Affective Disorders, 149(1–3), 129–135.

    Article  PubMed  Google Scholar 

  • Tuomilehto, J., Lindstrom, J., Eriksson, J. G., et al. (2001). Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. New England Journal of Medicine, 344(18), 1343–1350.

    Article  PubMed  Google Scholar 

  • Valkanova, V., & Ebmeier, K. P. (2013). Vascular risk factors and depression in later life: A systematic review and meta-analysis. Biological Psychiatry, 73(5), 406–413.

    Article  PubMed  Google Scholar 

  • van Dooren, F. E., Nefs, G., Schram, M. T., Verhey, F. R., Denollet, J., & Pouwer, F. (2013). Depression and risk of mortality in people with diabetes mellitus: A systematic review and meta-analysis. PloS One, 8(3), e57058.

    Article  PubMed  PubMed Central  Google Scholar 

  • von Kanel, R. (2004). Platelet hyperactivity in clinical depression and the beneficial effect of antidepressant drug treatment: How strong is the evidence? Acta Psychiatrica Scandinavica, 110(3), 163–177.

    Article  Google Scholar 

  • Vos, T., Flaxman, A. D., Naghavi, M., et al. (2012). Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: A systematic analysis for the global burden of disease study 2010. Lancet, 380(9859), 2163–2196.

    Article  PubMed  Google Scholar 

  • Wager-Smith, K., & Markou, A. (2011). Depression: A repair response to stress-induced neuronal microdamage that can grade into a chronic neuroinflammatory condition? Neuroscience and Biobehavioral Reviews, 35(3), 742–764.

    Article  PubMed  PubMed Central  Google Scholar 

  • Whooley, M. A., de Jonge, P., Vittinghoff, E., et al. (2008). Depressive symptoms, health behaviors, and risk of cardiovascular events in patients with coronary heart disease. JAMA, 300(20), 2379–2388.

    Article  PubMed  PubMed Central  Google Scholar 

  • Wilson, J. M. G., & Jungner, G. (1968). Principles and practice of screening for disease. Geneva: World Health Organisation.

    Google Scholar 

  • Ye, S., Muntner, P., Shimbo, D., et al. (2013). Behavioral mechanisms, elevated depressive symptoms, and the risk for myocardial infarction or death in individuals with coronary heart disease: The REGARDS (reason for geographic and racial differences in stroke) study. Journal of the American College of Cardiology, 61(6), 622–630.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Health Sciences and the EMGO+ Institute for Health and Care Research, VU University Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands

    Marcel Adriaanse

  2. Department of Medical and Clinical Psychology, Center of Research on Psychology in Somatic diseases (CoRPS), Tilburg University, Warandelaan 2, 5037 AB, Tilburg, The Netherlands

    Frans Pouwer

Authors
  1. Marcel Adriaanse
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Frans Pouwer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marcel Adriaanse .

Editor information

Editors and Affiliations

  1. Monash Cardiovascular Research Centre, Monash University, Melbourne, Victoria, Australia

    Marlies E. Alvarenga

  2. ANU Medical School, Australia National University, Canberra, Aust Capital Terr, Australia

    Don Byrne

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer Science+Business Media Singapore

About this entry

Cite this entry

Adriaanse, M., Pouwer, F. (2016). Diabetes, Depression, and Cardiovascular Risk. In: Alvarenga, M., Byrne, D. (eds) Handbook of Psychocardiology. Springer, Singapore. https://doi.org/10.1007/978-981-287-206-7_43

Download citation

Publish with us

Policies and ethics

Search

Navigation