Incidence of depression in type 2 diabetes patients with and without cardiovascular disease

Abstract

Abstract Background Information on how subtypes of incident cardiovascular disease (CVD) affect the rate of depression in patients with type 2 diabetes (T2D) can help identity high-risk patients. Purpose To compare the incidence of depression among patients with T2D with incident CVD relative to patients with T2D free of CVD but similar duration of T2D. Methods Patients diagnosed with incident T2D without CVD or psychiatric disease were identified from the Danish registries between 2000 and 2018. CVD was defined as the first diagnosis of acute myocardial infarction (AMI), heart failure (HF), stroke, or peripheral artery disease (PAD). The patients were followed 90 days after first T2D diagnosis until first occurrence of depression, emigration, death, one year after CVD development, or end of the study (December 31, 2019). We used time-dependent Poisson regression to estimate the incidence rate ratios (IRR) of depression following different types of CVD compared with patients without CVD. The model included age, sex, comorbidities, calendar year, T2D duration, educational level, and living situation as covariates. Results Among 175,916 incident T2D patients (median age 61 (IQR:51;70), 59% males) followed for 1,306,228 person-years (py), 34,825 experienced depression. The crude incidence rate of depression per 1000 py (95% confidence interval) in patients without CVD was 25.8 (16.8;37.9). Compared with T2D patients without CVD, adjusted IRR of depression following AMI, stroke, PAD, and HF was: 2.4 (1.8;3.1) 5.7 (5.3;6.2), 2.5 (2.2;2.9), 2.3 (2.1;2.6), respectively. Conclusions All CVDs was associated with increased rate of depression, but highest rate was seen in T2D patients with stroke.