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.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Alexopoulos, G. S. (2006). The vascular depression hypothesis: 10 years later. Biological Psychiatry, 60(12), 1304–1305.
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.
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.
American Diabetes Association. (2013). Standards of medical care in diabetes – 2013. Diabetes Care, 36(Suppl 1), S11–S66.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Publishing. Text revision.
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.
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.
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.
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.
Bluestone, J. A., Herold, K., & Eisenbarth, G. (2010). Genetics, pathogenesis and clinical interventions in type 1 diabetes. Nature, 464(7293), 1293–1300.
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.
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.
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.
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.
Cooney, G. M., Dwan, K., Greig, C. A., et al. (2013). Exercise for depression. Cochrane Database of Systematic Reviews, 9, CD004366.
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.
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.
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.
Donath, M. Y., & Shoelson, S. E. (2011). Type 2 diabetes as an inflammatory disease. Nature Reviews. Immunology, 11(2), 98–107.
Dowlati, Y., Herrmann, N., Swardfager, W., et al. (2010). A meta-analysis of cytokines in major depression. Biological Psychiatry, 67(5), 446–457.
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.
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.
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.
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.
Gilbody, S., Sheldon, T., & House, A. (2008). Screening and case-finding instruments for depression: A meta-analysis. CMAJ, 178(8), 997–1003.
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.
Golden, S. H., Lazo, M., Carnethon, M., et al. (2008). Examining a bidirectional association between depressive symptoms and diabetes. JAMA, 299(23), 2751–2759.
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.
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.
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.
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.
IDF Clinical Guidelines Task Force. (2012). Global guideline for type 2 diabetes. Brussels: International Diabetes Federation.
International Diabetes Federation. (2013). IDF diabetes atlas (6th ed.). Brussels: International Diabetes Federation.
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.
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.
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.
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.
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.
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.
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.
Krishnan, V., & Nestler, E. J. (2008). The molecular neurobiology of depression. Nature, 455(7215), 894–902.
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.
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.
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.
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.
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.
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.
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.
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.
Marshall, S. M., & Flyvbjerg, A. (2006). Prevention and early detection of vascular complications of diabetes. BMJ, 333(7566), 475–480.
Mathers, C. D., & Loncar, D. (2006). Projections of global mortality and burden of disease from 2002 to 2030. PLoS Medicine, 3(11), e442.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Roy, T., & Lloyd, C. E. (2012). Epidemiology of depression and diabetes: A systematic review. Journal of Affective Disorders, 142(Suppl), S8–S21.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Wilson, J. M. G., & Jungner, G. (1968). Principles and practice of screening for disease. Geneva: World Health Organisation.
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.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights 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
DOI: https://doi.org/10.1007/978-981-287-206-7_43
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-287-205-0
Online ISBN: 978-981-287-206-7
eBook Packages: Behavioral Science and PsychologyReference Module Humanities and Social SciencesReference Module Business, Economics and Social Sciences