Type 2 Diabetes and Depressive Symptoms

The onset of type 2 diabetes mellitus (T2DM) among women, but not men, is associated with high levels of depressive symptoms in both adolescence and adulthood, according to a new study.¹ The findings suggest that the onset of depression early in life might set up a trajectory of risk for T2DM among women.

Researchers, led by Shakira F. Suglia, Columbia University Mailman School of Public Health, examined the association between high levels of depressive symptoms in adolescence and T2DM in adulthood in the National Longitudinal Study of Adolescent to Adult Health. The 12,657 participants completed a depression inventory at a mean age 16 and repeated it again at mean age 29. T2DM was identified 13 years after baseline on the basis of either a glycated hemoglobin concentration of at least 6.5% or use of hypoglycemic medication (with or without insulin).

In models adjusted for demographic characteristics, women were at twice the risk of developing T2DM if they experienced high levels of depressive symptoms during both adolescence and adulthood than were those who did not experience symptoms at either time point. No statistically significant associations were noted among men.

The researchers suggest that behavioral factors and obesity might account for the association. “An association between symptoms of depression and type 2 DM might be attributable to obesity and behavioral factors such as lack of physical activity, smoking, alcohol consumption, and short sleep duration,” they stated.

They concluded that “our finding of a 3–4% incidence of type 2 DM in a nationally representative sample of 29-year-old persons, which is higher than in previous samples, warrants a focus on the identification and prevention of risk factors early in the life course.”

Social Support for Adolescents with T2DM

Diabetes disease management, depressive symptoms, and levels of social support may differ between early and middle adolescents, according to another new study.²

Researchers, led by Kristiana Cullum, PhD, CPNP, School of Nursing, San Diego State University, conducted a cross-sectional, descriptive, correlational study. They surveyed 31 adolescents, mean age 15 years, at an endocrinology clinic regarding depressive symptoms and perceived social support.

The adolescents had a level of reported depressive symptoms that is more than double of adolescents in general or for adults with diabetes.

Mean depressive symptoms scores were higher among early adolescents. “Middle adolescents had lower body mass index percentiles, but higher A1C levels,” they stated. Early adolescents had greater mean scores of social support; they reported that this support was more important compared with middle adolescents.

Because T2DM is a growing problem among adolescents, researchers and clinicians have focused on obesity prevention. “For overweight adolescents with type 2 diabetes, the challenge of losing weight and managing their disease may be overwhelming as they strive for an independent sense of self and the desire to fit in with peers. Increasing social support, including online social networks, may lessen the burden of disease management and, in turn, improve their ability to successfully manage their disease,” the researchers stated.

References:

1. Suglia SF, et al. Depressive symptoms during adolescence and young adulthood and the development of type 2 diabetes mellitus. Am J Epidemiol. 2016 Feb 15;183(4):269-276.

2. Cullum K, et al. Depressive symptoms and social support in adolescents with type 2 diabetes. J Pediatr Health Care. 2016 Jan-Feb;30(1):57-64.