A history of anxiety and depression found to worsen glycemic control in type 2 diabetes

This study examined the effect of lifetime depression and anxiety on current psychological symptoms and diabetes behavior and control in patients with type 2 diabetes (T2D).

In T2D levels of glucose in the blood are elevated. Proper glycemic control (control of blood glucose levels) is essential to prevent long-term complications of T2D, such as blindness or kidney disease.

Many people with T2D have anxiety and depression symptoms. These symptoms have been associated with poor glycemic control. A history of depression has been associated with an increased risk of current depression and increased risk of diabetes complications. The impact of a history of anxiety has not been examined.

The current study examined the association between lifetime depression or anxiety and current symptoms and diabetes control. 1285 T2D patients were included. Patients answered questionnaires that assessed the severity of current depression and anxiety symptoms. Questionnaires also assessed a history of depression (lifetime major depressive disorder, L-MDD) and anxiety (lifetime generalized anxiety disorder, L-GAD). The participants’ HbA1C (average measure of blood glucose over the past 3 months), self-monitoring of blood glucose (SMBG), body mass index (BMI, a measure of body fat that takes height and weight into account), and smoking were also examined.

L-MDD and L-GAD were associated with an increased severity of current depression and anxiety symptoms. This was true even when considering factors like age, gender, and marital status.

The increase in current depression symptoms was associated with higher HbA1C levels, less frequent SMBG, higher BMI, and a greater prevalence of smoking. Having both L-MDD and L-GAD at the same time also increased the severity of current anxiety and depression symptoms, compared to having just one or the other.

This study concluded that a history of anxiety and depression are important risk factors for current psychological symptoms, poorer health behavior, and worse glycemic control in patients with T2D. The authors suggested patients should be screened for these disorders at the time of T2D diagnosis.

Diagnosis of L-MDD, L-GAD, as well as current anxiety and depression symptoms in this study relied on the honesty of the participants. Furthermore, smoking behavior and SMBG were reported by the participants and not measured directly by the researchers.

The results of this study have not yet received any follow up. This makes the results hard to confirm.  Follow up for this study is ongoing, so stronger evidence supporting its claims may emerge later. 

Consider asking your physician about the need to test for anxiety and depression. If you are diagnosed with L-GAD and/or L-MDD and T2D, discuss proper glycemic control and monitoring with your physician.