Association between Depression, Antidepression Medications, and the Risk of Developing Type 2 Diabetes Mellitus: A Nationwide Population-Based Retrospective Cohort Study in Taiwan.

Yi-Jen Fang,Jung-Nien Lai,Cheng-Li Lin,Ni Tien,Yun-Ping Lim,Tien-Yuan Wu,Ali Abbara

doi:10.1155/2021/8857230

Abstract

The relationship between depression, antidepressant medications (ADMs), and the risk of subsequent type 2 diabetes mellitus (T2DM) development remains controversial. Thus, we investigated this aspect by a population-based retrospective cohort study using the Longitudinal Health Insurance Database 2000 available in Taiwan. This large, observational study included 46,201 patients with depression and a 1 : 1 age- and sex-matched nondepression cohort enrolled between January 1, 2000, and December 31, 2013, and the newly diagnosed T2DM incidence rates were determined. We estimated the effects of depression on T2DM and the cumulative incidence curves by Cox proportional regression hazard models and Kaplan-Meier methods, respectively. We found that 47.97% of the patients with depression did not receive ADM. Among patients with depression who received ADM, 29.71%, 6.29%, 0.05%, 9.65%, and 6.32% received selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), heterocyclic antidepressants, and other medications, respectively. Patients without ADM treatment had a 39% higher risk of developing T2DM. However, those who received ADM treatment had a significantly lower risk of T2DM development in every treatment category. Depressive disorder treated with ADMs, especially with long-term use, was associated with an 11–48% decrease in the risk of T2DM in all ADM groups; however, heterocyclic antidepressant treatment for shorter periods (<80 days) was not significantly associated with a decreased risk of T2DM. The incidence of T2DM in Taiwan was found to be associated with an a priori history of depression and was inversely correlated with ADM treatment.

Highlights

The global prevalence of age-standardized type 2 diabetes mellitus (T2DM) was predicted to be 9.3% (463 million people) in 2019, and it is projected to rise to 10.2% (578 million) and 10.9% (700 million) by 2030 and 2045, respectively [1]
The risk of T2DM was significantly lower for heterocyclic users for ≥80 days compared with heterocyclic nonusers (Table 4). In this comprehensive nationwide population-based cohort study, we investigated the possible association of depression and the development of T2DM under antidepressant medications (ADMs) therapy
We found that (1) the overall association of depression and T2DM was 17% higher in the depression cohort than in the comparison cohort; (2) patients with depression who were not treated with ADMs had a 39% higher risk of T2DM development compared to the comparison cohort; and (3) after treatment with ADMs, the incidence of T2DM was lower in patients with depression than in those without

Summary

Introduction

The global prevalence of age-standardized type 2 diabetes mellitus (T2DM) was predicted to be 9.3% (463 million people) in 2019, and it is projected to rise to 10.2% (578 million) and 10.9% (700 million) by 2030 and 2045, respectively [1]. The risk factors associated with T2DM are multiplex but largely comprise rapid increases in overweight, high body mass index, less physical activity, sedentary lifestyles, and high frequencies of high fat intake. A few studies have demonstrated depression to be a risk factor or to be associated with the development of T2DM [2, 3]. Some researchers report that depression is associated with an increased risk of developing T2DM, whereas other studies have found no significant association. The exact mechanisms underlying this correlation are still uncertain and need further investigation

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Results

Conclusion