Abstract
Aim To determine the efficacy and safety of vitamin D3 supplementation in reducing depressive symptoms in women with type 2 diabetes (T2D), depression, and low vitamin D. Methods In this double-blind randomized active comparator-controlled trial, women with significant depressive symptoms as assessed by the Center for Epidemiologic Studies Depression (CES-D) scale received weekly oral vitamin D3 supplementation (50,000 IU) or an active comparator (5,000 IU) for 6 months. Assessments of vitamin D, 25-hydroxyvitamin D [25 (OH) D], and depression were measured at baseline, 3 months, and 6 months. Results A total of 129 women were randomized, from which 119 completed the study (57 in lower dose and 62 in higher dose). Participants had an average 25 (OH) D and HbA1c of 20.8 ng/mL and 7.8%, respectively, at baseline. They were diverse (48% Black) and had a mean age of 50 and T2D for about 8 years. Upon completion of vitamin D3 supplementation, serum 25 (OH) D levels increased with 50,000 IU (+34 ng/mL) and 5,000 IU (+10 ng/mL). There was no difference in CES-D scores by treatment dose. Overall, depressive symptoms significantly improved over time with an average CES-D decline of 12.98 points (95% CI: −15.04 to −10.93; p < 0.001). Among women with moderate baseline depressive symptoms, those receiving the lower dose had nominally lower depression scores at follow-up than those in the higher dose cohort. Among women with severe baseline depressive symptoms, the improvement in follow-up depression scores was the same regardless of dose. Conclusions There was no difference in the dosing effect of vitamin D3 supplementation for the treatment of depressive symptoms in women with T2D who present with significant symptoms and low vitamin D. Regardless of the dose, participants' mood improved over time. Further study of vitamin D to target depressive symptoms in comorbid populations is needed.
Highlights
Depression affects women almost twice as often than men with diabetes [1]
More than 25% of women with diabetes (T2D) have depression and it increases their risk for poor health outcomes [2]
In a recent international study assessing the prevalence and management of depressive disorders in people receiving care in diabetes centers, the female gender was found to be a predictor of major depressive disorder (MDD) [4]
Summary
Depression affects women almost twice as often than men with diabetes [1]. More than 25% of women with diabetes (T2D) have depression and it increases their risk for poor health outcomes [2]. For women having both depression and diabetes, the risk of mortality is significantly higher (relative risk, RR = 3:11) than that for having either diabetes (RR = 1:71) or depression (RR = 1:76) alone [3]. Antidepressants effectively relieve depression and its related symptoms in persons with T2D [6]. Some antidepressants are twice as likely to assist individuals to achieve glycemic control [7]. A side effect of antidepressants, is weight gain which can make compliance challenging [8].
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