Is the Association Between Depressive Symptoms and Glucose Metabolism Bidirectional? Evidence From the English Longitudinal Study of Ageing
Open accessAbstract
OBJECTIVE: To examine whether the prospective association between depressive symptoms and glucose metabolism is bidirectional. METHODS: We used a national sample of 4238 community-dwelling individuals 50 years or older from the English Longitudinal Study of Ageing. Participants were categorized into normoglycemic, impaired glucose metabolism (IGM), and undiagnosed and diagnosed diabetes using glycated hemoglobin and self-reported doctor diagnosis. Subthreshold and elevated depressive symptoms were defined by a score between 2 and 3 and 4 or higher, respectively, on the eight-item Center for Epidemiological Studies-Depression scale. RESULTS: In the age-adjusted model, categories of depressive symptoms were associated with incident undiagnosed (odds ratio [OR] = 1.54 [95% confidence interval {CI} = 0.86-2.73] and OR = 1.91 [95% CI = 1.03-3.57] for subthreshold and elevated depressive symptoms, respectively) and diagnosed diabetes (OR = 1.53 [95% CI = 0.80-2.93] and OR = 3.03 [95% CI = 1.66-5.54], respectively) for 6 years of follow-up. The latter association remained significant after adjustment for covariates. Depressive symptoms were not associated with future IGM. Diagnosed diabetes was associated with future elevated depressive symptoms in participants aged 52 to 64 years (OR = 2.17, [95% CI = 1.33-3.56]), but not those 65 years and older (OR = 0.96, [95% CI = 0.59-1.57]) for 4 years of follow-up. Adjustment for covariates partially explained this association. IGM and undiagnosed diabetes were not associated with subsequent elevated depressive symptoms. CONCLUSIONS: These data suggest that there is a bidirectional association between depressive symptoms and diagnosed diabetes in people aged 52 to 64 years but not in people 65 years and older.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Depressive symptoms and a diagnosis of clinical depression are predictive of future development of diabetes mellitus.
“Depressive symptoms, such as loss of pleasure and feelings of hopelessness, and a diagnosis of clinical depression are predictive of future development of diabetes mellitus 67, 68”
From Type 2 diabetes mellitus and psychological stress — a modifiable risk factor (2017) · cites this paper as [67]
The Discussion (‘Depressive symptoms as a predictor of glucose metabolism’; page not provided) reports that depressive symptoms predicted a later diabetes diagnosis. The paper does not establish the same finding for a clinical diagnosis of depression: it describes prior evidence on depressive disorder and incident diabetes as limited and inconsistent. (LLM, conf=0.86)
Experimental — accuracy not yet measuredIn the ELSA cohort (n=4,238; 6 year follow-up), depressive symptoms measured by CES-D are associated with diabetes risk (OR 1.53, 95% CI 0.80-2.93).
“| ELSA cohort ( n = 4,238; 6 year follow-up) | Depressive symptoms using the eight-item centre for epidemiologic studies- depression scale (CES-D) | OR 1.53 (95% CI 0.80- 2.93)*. |”
From Type 2 diabetes mellitus and psychological stress — a modifiable risk factor (2017) · cites this paper as Demakakos (2014) 61
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredDepression is associated with an increased risk of diabetes mellitus.
“Results from meta-analyses and prospective cohort studies indicate that depression is associated with an increased risk of diabetes mellitus 65-68”
From Type 2 diabetes mellitus and psychological stress — a modifiable risk factor (2017) · cites this paper as [67]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The CES-D Scale: A Self-Report Depression Scale for Research in the General Population
Radloff, L. S. (1977) · Applied Psychological Measurement · doi:10.1177/014662167700100306 · Cited by 53,267 · see citing works
Diagnosis and Classification of Diabetes Mellitus
American Diabetes Association (2010) · Diabetes Care · doi:10.2337/dc11-s062 · Cited by 14,019 · see citing works
The Prevalence of Comorbid Depression in Adults With Diabetes
Anderson, R. J., Freedland, K. E., Clouse, R. E., & Lustman, P. J. (2001) · Diabetes Care · doi:10.2337/diacare.24.6.1069 · Cited by 3,926 · see citing works
Diagnosis and Classification of diabetes mellitus
Rossi, G. (2014) · Diapedia.org eBooks · doi:10.14496/dia..20 · Cited by 3,212 · see citing works
Prediabetes: a high-risk state for diabetes development
Tabák, A. G., Herder, C., Rathmann, W., Brunner, E. J., & Kivimäki, M. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60283-9 · Cited by 2,958 · see citing works
Depression and Type 2 Diabetes Over the Lifespan
Mezuk, B., Eaton, W. W., Albrecht, S., & Golden, S. H. (2008) · Diabetes Care · doi:10.2337/dc08-0985 · Cited by 1,558 · see citing works
Diagnosis and Classification of Diabetes Mellitus
American Diabetes Association (2011) · Diabetes Care · doi:10.2337/dc12-s064 · Cited by 1,494 · see citing works
Ali, S., Stone, M. A., Peters, J., Davies, M. J., & Khunti, K. K. (2006) · Diabetic Medicine · doi:10.1111/j.1464-5491.2006.01943.x · Cited by 1,281 · see citing works
Active Smoking and the Risk of Type 2 Diabetes: A Systematic Review and Meta-analysis
Willi, C., Bodenmann, P., Ghali, W. A., Faris, P. D., & Cornuz, J. (2007) · JAMA · doi:10.1001/jama.298.22.2654 · Cited by 1,268 · see citing works
Screening for Depression in the Older Adult
Irwin, M. R., Artin, K. H., & Oxman, M. N. (1999) · Archives of Internal Medicine · doi:10.1001/archinte.159.15.1701 · Cited by 1,220 · see citing works
Depression as a risk factor for the onset of type 2 diabetes mellitus. A meta-analysis
Knol, M. J., Twisk, J. W. R., Beekman, A. T. F., Heine, R. J., Snoek, F. J., & Pouwer, F. (2006) · Diabetologia · doi:10.1007/s00125-006-0159-x · Cited by 974 · see citing works
Examining a Bidirectional Association Between Depressive Symptoms and Diabetes
Golden, S. H. (2008) · JAMA · doi:10.1001/jama.299.23.2751 · Cited by 890 · see citing works
Abdullah, A., Peeters, A., de Courten, M., & Stoelwinder, J. (2010) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2010.04.012 · Cited by 824 · see citing works
Physical Activity/Exercise and Type 2 Diabetes
Sigal, R. J., Kenny, G. P., Wasserman, D. H., & Castaneda-Sceppa, C. (2004) · Diabetes Care · doi:10.2337/diacare.27.10.2518 · Cited by 763 · see citing works
for the European Depression in Diabetes (EDID) Research Consortium, Nouwen, A., Winkley, K., Twisk, J., Lloyd, C. E., Peyrot, M., Ismail, K., & Pouwer, F. (2010) · Diabetologia · doi:10.1007/s00125-010-1874-x · Cited by 756 · see citing works
Self-citationRelationship of depression to diabetes types 1 and 2: epidemiology, biology, and treatment
Musselman, D. L., Betan, E. J., Larsen, H., & Phillips, L. S. (2003) · Biological Psychiatry · doi:10.1016/s0006-3223(03)00569-9 · Cited by 670 · see citing works
Strine, T. W., Mokdad, A. H., Dube, S. R., Balluz, L. S., Gonzalez, O., Berry, J. T., Manderscheid, R., & Kroenke, K. (2008) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2007.12.008 · Cited by 577 · see citing works
Bidirectional Association Between Depression and Type 2 Diabetes Mellitus in Women
Pan, A., Lucas, M., Sun, Q., van Dam, R. M., Franco, O. H., Manson, J. E., Willett, W. C., Ascherio, A., & Hu, F. B. (2010) · Archives of Internal Medicine · doi:10.1001/archinternmed.2010.356 · Cited by 447 · see citing works
Shortening the CES-D to improve its ability to detect cases of depression.
Santor, D. A., & Coyne, J. C. (1997) · Psychological Assessment · doi:10.1037/1040-3590.9.3.233 · Cited by 422 · see citing works
A review of the relationship between depression and diabetes in adults: is there a link?
Talbot, F., & Nouwen, A. (2000) · Diabetes Care · doi:10.2337/diacare.23.10.1556 · Cited by 410 · see citing works
Self-citationA Systematic Review and Meta-analysis of the Association Between Depression and Insulin Resistance
Kan, C., Silva, N., Golden, S. H., Rajala, U., Timonen, M., Stahl, D. R., & Ismail, K. (2013) · Diabetes Care · doi:10.2337/dc12-1442 · Cited by 363 · see citing works
Depression and type 2 diabetes: Inflammatory mechanisms of a psychoneuroendocrine co-morbidity
Stuart, M. J., & Baune, B. T. (2012) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2011.10.001 · Cited by 257 · see citing works
Depressive symptoms and occurrence of type 2 diabetes among Japanese men.
Kawakami, N., Takatsuka, N., Shimizu, H., & Ishibashi, H. (1999) · Diabetes Care · doi:10.2337/diacare.22.7.1071 · Cited by 253 · see citing works
Prevalence of Depression in Individuals With Impaired Glucose Metabolism or Undiagnosed Diabetes
Nouwen, A., Nefs, G., Caramlau, I. O., Connock, M. J., Winkley, K., Lloyd, C. E., Peyrot, M. F., & Pouwer, F. (2011) · Diabetes Care · doi:10.2337/dc10-1414 · Cited by 251 · see citing works
Self-citationCarnethon, M. R. (2003) · American Journal of Epidemiology · doi:10.1093/aje/kwg172 · Cited by 244 · see citing works
Mojtabai, R., & Olfson, M. (2004) · Psychological Medicine · doi:10.1017/s0033291703001764 · Cited by 242 · see citing works
Depressive Symptoms, Insulin Resistance, and Risk of Diabetes in Women at Midlife
Everson‐Rose, S. A., Meyer, P., Powell, L. H., Pandey, D. K., Torréns, J. I., Kravitz, H. M., Bromberger, J. T., & Matthews, K. A. (2004) · Diabetes Care · doi:10.2337/diacare.27.12.2856 · Cited by 237 · see citing works
Screening for Diabetes and Pre-Diabetes With Proposed A1C-Based Diagnostic Criteria
Olson, D. E., Rhee, M. K., Herrick, K., Ziemer, D. C., Twombly, J. G., & Phillips, L. S. (2010) · Diabetes Care · doi:10.2337/dc10-0433 · Cited by 234 · cited 2× · see citing works
“Similarly, the ADA classification of HbA1c might have led to a misclassification of cases of IGM (32), which in turn might have biased our IGM-related results toward the null.”
Depressive Symptoms and the Risk of Type 2 Diabetes
Golden, S. H., Williams, J. E., Ford, D. E., Yeh, H., Sanford, C. P., Nieto, F. J., & Brancati, F. L. (2004) · Diabetes Care · doi:10.2337/diacare.27.2.429 · Cited by 233 · see citing works
Eriksson, A. ‐., Ekbom, A., Granath, F., Hilding, A., Efendic, S., & Östenson, C. ‐. (2008) · Diabetic Medicine · doi:10.1111/j.1464-5491.2008.02463.x · Cited by 215 · see citing works
Association of C-reactive protein with type 2 diabetes: prospective analysis and meta-analysis
Lee, C.-T., Adler, A., Sandhu, M. S., Sharp, S. J., Forouhi, N. G., Erqou, S. A., Luben, R., Bingham, S. A., Khaw, K., & Wareham, N. J. (2009) · Diabetologia · doi:10.1007/s00125-009-1338-3 · Cited by 201 · see citing works
Depressive Disorder and Incident Diabetes Mellitus: The Effect of Characteristics of Depression
Campayo, A., de Jonge, P., Delgado, J. F. R., Saz, P., de la Cámara, C., Quintanilla, M. A., Marcos, G., Santabárbara, J., & Lobo, A. (2010) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2009.09010038 · Cited by 196 · see citing works
Stewart, T. L., Chipperfield, J. G., Perry, R. P., & Weiner, B. (2012) · Psychology & Health · doi:10.1080/08870446.2011.630735 · Cited by 162 · see citing works
Health Service Utilization and Costs of Depressive Symptoms in Late Life - A Systematic Review
Luppa, M., Sikorski, C., Motzek, T., Konnopka, A., Konig, H.-H., & G. Riedel-Heller, S. (2012) · Current Pharmaceutical Design · doi:10.2174/138161212803523572 · Cited by 108 · see citing works
Patient age: A neglected factor when considering disease management in adults with type 2 diabetes
Hessler, D., Fisher, L., Mullan, J. T., Glasgow, R. E., & Masharani, U. B. (2010) · Patient Education and Counseling · doi:10.1016/j.pec.2010.10.030 · Cited by 95 · see citing works
Lawlor, D. A., Ben‐Shlomo, Y., Ebrahim, S. B. J., Smith, G. D., Stansfeld, S. A., YARNELL, J. W. G., & Gallacher, J. (2005) · BMJ · doi:10.1136/bmj.38377.616921.f7 · Cited by 58 · see citing works
Risk of depression in diabetes is highest for young persons using oral anti‐diabetic agents
Berge, L. I., Riise, T., Fasmer, O. B., Lund, A., Oedegaard, K., & Hundal, Ø. (2011) · Diabetic Medicine · doi:10.1111/j.1464-5491.2011.03530.x · Cited by 25 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Evaluating Digital Health Interventions
Murray, E., Hekler, E. B., Andersson, G., Collins, L. M., Doherty, A., Hollis, C., Rivera, D. E., West, R., & Wyatt, J. C. (2016) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2016.06.008 · Cited by 847 · see citing works
Type 2 diabetes mellitus and psychological stress — a modifiable risk factor
Hackett, R. A., & Steptoe, A. (2017) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2017.64 · Cited by 480 · see citing works
Nouwen, A., Adriaanse, M. C., van Dam, K., Iversen, M. M., Viechtbauer, W., Peyrot, M., Caramlau, I., Kokoszka, A., Kanc, K., de Groot, M., et al. (2019) · Diabetic Medicine · doi:10.1111/dme.14054 · Cited by 301 · see citing works
Self-citationPsychosocial Factors in Diabetes and Cardiovascular Risk
Hackett, R. A., & Steptoe, A. (2016) · Current Cardiology Reports · doi:10.1007/s11886-016-0771-4 · Cited by 152 · see citing works
Guerrero Fernández de Alba, I., Gimeno-Miguel, A., Poblador-Plou, B., Gimeno-Feliu, L. A., Ioakeim-Skoufa, I., Rojo-Martínez, G., Forjaz, M. J., & Prados-Torres, A. (2020) · Scientific Reports · doi:10.1038/s41598-020-76546-9 · Cited by 84 · see citing works
- Authors
- Demakakos, P., Zaninotto, P., & Nouwen, A.
- Affiliations
- University College London (GB)
- Corresponding author
- Demakakos, Panayotes
- Venue
- Psychosomatic Medicine
- Published
- 2014-09
- Volume
- 76
- Issue
- 7
- Pages
- 555-561
- ISSN
- 0033-3174 (ISSN-L)
- PMC
- PMC4458700
- OpenAlex
- W1969712029
- Semantic Scholar
- f10778137abbcb2dbfa40fe4fa83996b0c01e8b0
- Cited by
- 58
- References
- 37
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 2 · 2023: 4 · 2022: 6 · 2021: 7 · 2020: 3 · 2019: 4 · 2018: 4 · 2017: 10 · 2016: 6 · 2015: 6
- FWCI
- 5.90
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychosomatic Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Middlesex University Research Repository (Middlesex University Of London) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- National Institute on Aging (2R01AG7644-01A1, R01AG017644)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Social Sciences › Health › Health disparities and outcomes
- Keywords
- depressive symptoms, glucose metabolism, diabetes mellitus, impaired glucose metabolism, bidirectional relationship, older adults, subthreshold depression, HbA1c, new-onset diabetes, age differences
- MeSH terms
- Age Factors, Aged, Depression, Diabetes Mellitus, Type 2, England, Female, Glucose, Glycated Hemoglobin, Humans, Longitudinal Studies, Male, Middle Aged, Psychiatric Status Rating Scales
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
