Cited by 1,799Diabetes Management and EducationDiabetes Management and ResearchDiabetes, Cardiovascular Risks, and Lipoproteins

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Association of Depression and Diabetes Complications: A Meta-Analysis

de Groot, Mary, Anderson, Ryan, Freedland, Kenneth E., Clouse, Ray E., Lustman, Patrick J.·2001·Psychosomatic Medicine

DOI 10.1097/00006842-200107000-00015

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Abstract

OBJECTIVE: The objective of this study was to examine the strength and consistency of the relationship between depression and diabetes complications in studies of type 1 and type 2 adult patients with diabetes. METHOD: MEDLINE and PsycINFO databases were searched for articles examining depression and diabetes complications in type 1 and type 2 diabetes samples published between 1975 and 1999. Meta-analytic procedures were used. Studies were reviewed for diabetes type, sample size, statistical tests, and measures of diabetes complications and depression. Significance values, weighted effect sizes r, 95% confidence intervals (CI), and tests of homogeneity of variance were calculated for the overall sample (k = 27) and for subsets of interest. RESULTS: A total of 27 studies (total combined N = 5374) met the inclusion criteria. A significant association was found between depression and complications of diabetes (p < .00001, z = 5.94). A moderate and significant weighted effect size (r = 0.25; 95% CI: 0.22-0.28) was calculated for all studies reporting sufficient data (k = 22). Depression was significantly associated with a variety of diabetes complications (diabetic retinopathy, nephropathy, neuropathy, macrovascular complications, and sexual dysfunction). Effect sizes were in the small to moderate range (r = 0.17 to 0.32). CONCLUSIONS: These findings demonstrate a significant and consistent association of diabetes complications and depressive symptoms. Prospective, longitudinal studies are needed to identify the pathways that mediate this association.

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Authors: de Groot, M., Anderson, R., Freedland, K. E., Clouse, R. E., & Lustman, P. J.
Affiliations: Washington University in St. Louis (US)
ORCID: Freedland, Kenneth E.
Lustman, Patrick J.
Venue: Psychosomatic Medicine
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2001-07
Volume: 63
Issue: 4
Pages: 619-630
ISSN: 0033-3174 (ISSN-L)
DOI: 10.1097/00006842-200107000-00015
OpenAlex: W2080312294
Cited by: 1,799
References: 40
Citations by year: 2026: 22 · 2025: 30 · 2024: 54 · 2023: 54 · 2022: 82 · 2021: 69 · 2020: 61 · 2019: 81 · 2018: 83 · 2017: 85 · 2016: 119 · 2015: 107 · 2014: 122 · 2013: 98 · 2012: 111
FWCI: 3.84
Type: journal article
Language: en
Open access: closed
Locations: Psychosomatic Medicine (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (5r01dk053060-05)
National Heart, Lung, and Blood Institute (T32HL007456, 5 T32 HL07456-18)
National Institute of Diabetes and Digestive and Kidney Diseases (DK-36452, DK53060, R01DK036452)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords: depression, diabetes complications, type 1 diabetes, type 2 diabetes, diabetic retinopathy, diabetic nephropathy, diabetic neuropathy, macrovascular complications, sexual dysfunction, depressive symptoms
MeSH terms: Depressive Disorder, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Diabetic Nephropathies, Diabetic Neuropathies, Diabetic Retinopathy, Humans, Risk Factors, Sick Role, Comorbidity

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Association of Depression and Diabetes Complications: A Meta-Analysis

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