Effects of Light Therapy on Mood and Insulin Sensitivity in Patients With Type 2 Diabetes and Depression: Results From a Randomized Placebo-Controlled Trial
Open accessAbstract
OBJECTIVE Depression is common in patients with type 2 diabetes and adversely affects quality of life and diabetes outcomes. We assessed whether light therapy, an antidepressant, improves mood and insulin sensitivity in patients with depression and type 2 diabetes. RESEARCH DESIGN AND METHODS This randomized, double-blind, placebo-controlled trial included 83 patients with depression and type 2 diabetes. The intervention comprised 4 weeks of light therapy (10,000 lux) or placebo light therapy daily at home. Primary outcomes included depressive symptoms (Inventory of Depressive Symptomatology [IDS]) and insulin sensitivity (M-value derived from the results of a hyperinsulinemic-euglycemic clamp). Secondary outcomes were related psychological and glucometabolic measures. RESULTS Intention-to-treat analysis showed that light therapy was not superior to placebo in reducing depressive symptoms (−3.9 IDS points [95% CI −9.0 to 1.2]; P = 0.248) and had no effect on insulin sensitivity (0.15 mg/kg*min [95% CI −0.41 to 0.70]; P = 0.608). Analyses incorporating only those participants who accurately adhered to the light therapy protocol (n = 51) provided similar results, but did suggest positive effects of light therapy on depression response rates (≥50% reduction in IDS points) (26% more response; P = 0.031). Prespecified analysis showed effect moderation by baseline insulin sensitivity (P = 0.009) and use of glucose-lowering medication (P = 0.023). Light therapy did not affect depressive symptoms in participants with higher insulin sensitivity or those who use only oral glucose-lowering medication or none at all, but it did produce a relevant effect in participants with lower insulin sensitivity (−12.9 IDS points [95% CI −21.6 to −4.2]; P = 0.017) and a trend toward effectiveness in those using insulin (−12.2 IDS points [95% CI −21.3 to −3.1]; P = 0.094). Light therapy was well tolerated. CONCLUSIONS Although this trial is essentially inconclusive, secondary analyses indicate that light therapy might be a promising treatment for depression among a subgroup of highly insulin-resistant individuals with type 2 diabetes.
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Patients with diabetes are prone to have anxiety, depression, stress, or other negative emotions.
“Patients with diabetes are prone to have anxiety, depression, stress, or other negative emotions [66][67][68] .”
From The efficacy of cognitive behavioral therapy-based intervention on patients with diabetes: a meta-analysis (2022) · cites this paper as [67]
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- Authors
- Brouwer, A., van Raalte, D. H., Nguyen, H.-T., Rutters, F., van de Ven, P. M., Elders, P. J. M., Moll, A. C., Van Someren, E. J. W., Snoek, F. J., Beekman, A. T. F., & Bremmer, M. A.
- Affiliations
- Amsterdam Public Health (NL)
- Amsterdam UMC, Vrije Universiteit, Department of Internal Medicine, Diabetes Center, Amsterdam, the Netherlands
- Amsterdam University Medical Centers (NL)
- Amsterdam UMC, Vrije Universiteit, Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam, the Netherlands
- Amsterdam UMC, Vrije Universiteit, and GGZ inGeest, Department of Psychiatry, Amsterdam Public Health research institute, Amsterdam, the Netherlands
- Corresponding author
- Brouwer, Annelies
- ORCID
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2019-03-11
- Volume
- 42
- Issue
- 4
- Pages
- 529-538
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2917279149
- Cited by
- 42
- References
- 43
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 7 · 2023: 7 · 2022: 6 · 2021: 6 · 2020: 5 · 2019: 1
- FWCI
- 2.79
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- KNAW research portal (Royal Academy of Art and Sciences (KNAW)) (publishedVersion)
- VU Research Portal (publishedVersion, other-oa)
- Pure Amsterdam UMC (acceptedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- KNAW Research Portal (The Royal Netherlands Academy of Arts and Sciences) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- European Foundation for the Study of Diabetes
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- phototherapy, depression, type 2 diabetes, insulin sensitivity, insulin resistance, depressive symptoms, mood, hyperinsulinemic-euglycemic clamp, medication adherence, antidepressant effects
- MeSH terms
- Affect, Aged, Depression, Diabetes Mellitus, Type 2, Double-Blind Method, Female, Humans, Insulin Resistance, Male, Middle Aged, Phototherapy, Placebos, Quality of Life, Treatment Outcome
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