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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BackgroundInfluential
Study protocol of the Diabetes and Depression Study (DAD): a multi-center randomized controlled trial to compare the efficacy of a diabetes-specific cognitive behavioral group therapy versus sertraline in patients with major depression and poorly controlled diabetes mellitus
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“Overall, the comorbidity of depression and diabetes is associated with adverse diabetes outcomes, especially higher hemoglobin A1c (HbA1c) levels [6], micro- and macrovascular complications [7], mortality [8,9], greater diabetes-related symptom burden [10], increased functional impairment, and poorer adherence to diet…”
Background
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Endocrine and inflammatory profiles in type 2 diabetic patients with and without major depressive disorder
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Healthy Eating Index scores associated with symptoms of depression in Cuban-Americans with and without type 2 diabetes: a cross sectional study
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Reestablishment of the hyperglycemia to the normal levels seems not to be essential to the anxiolytic-like effect induced by insulin
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Longitudinal investigation of the reciprocal relationship between depressive symptoms and glycemic control: The moderation effects of sex and perceived support
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Depression and glycemic control in adolescent diabetics: evaluating possible association between depression and hemoglobin A1c
Picozzi, A., & DeLuca, F. (2019) · Public Health · doi:10.1016/j.puhe.2019.02.005 · Cited by 24
Why Are Individuals With Diabetes Less Active? The Mediating Role of Physical, Emotional, and Cognitive Factors
Cheval, B., Maltagliati, S., Sieber, S., Beran, D., Chalabaëv, A., Sander, D., Cullati, S., & Boisgontier, M. P. (2021) · Annals of Behavioral Medicine · doi:10.1093/abm/kaaa120 · Cited by 22
The evaluation of the Turkish version of the Well-being Questionnaire (WBQ-22) in patients with Type 2 diabetes: The effects of diabetic complications
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Epidemiology, treatment and costs of depression in adults with Type 2 diabetes
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Self-citation
Depression Screening Disparities Among Veterans With Diabetes Compared With the General Veteran Population
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Serum Levels of CRP are Associated with Depression in a Middle-aged and Elderly Population with Diabetes Mellitus: A Diabetes Mellitus-Stratified Analysis in a Population-Based Study
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Do competing demands of physical illness in type 2 diabetes influence depression screening, documentation and management in primary care: a cross-sectional analytic study in Aboriginal and Torres Strait Islander primary health care settings
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Background
Positive association between serious psychiatric outcomes and complications of diabetes mellitus in patients with depressive disorders
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Reduction of Depressive Symptoms in an Elderly Mexican‐American Female with Type 2 Diabetes Mellitus: A Single‐Subject Study
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Depressive Disorders Among Cohorts of Women Veterans with Diabetes, Heart Disease, and Hypertension
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Background
Depression and Risk Perceptions in Older African Americans With Diabetes
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Outpatient Management of Eating Disorders in Type 1 Diabetes
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Alexithymia, more than depression, influences glycaemic control of type 2 diabetic patients
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Type 1 Diabetes Mellitus
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Management of Comorbidities in Older Persons With Type 2 Diabetes
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Effect of a Behavioural Intervention for Adoption and Maintenance of a Physically Active Lifestyle on Psychological Well-Being and Quality of Life in Patients with Type 2 Diabetes: The IDES_2 Randomized Clinical Trial
Nicolucci, A., Haxhi, J., D’Errico, V., Sacchetti, M., Orlando, G., Cardelli, P., Vitale, M., Bollanti, L., Conti, F., Zanuso, S., et al. (2022) · Sports Medicine · doi:10.1007/s40279-021-01556-0 · Cited by 19

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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