DOC News July 1, 2007
Volume 4 Number 7 p. 15
© 2007 American Diabetes Association
Depression a Diabetes Risk Factor Independent of BMI
Bruce Goldfarb
The presence of high levels of depressive symptoms is an independent risk
factor for diabetes regardless of body mass index (BMI), according to a new
analysis reported at the Diabetes Translation Conference sponsored by the
Centers for Disease Control and Prevention, held April 30–May 3 in
Atlanta.
Bruce S. Jonas, PhD, of the National Center for Health Statistics,
presented results from an analysis of the National Health and Nutrition
Examination Survey (NHANES I) follow-up study, which tracked 4,898 adults for
17 years. None of the participants had diabetes at baseline.
In every category of BMI, participants found to have high levels of
depression symptoms on standardized tests were significantly more likely to
have diabetes, according to Jonas. People who reported high levels of
depression symptoms were about twice as likely to develop type 2 diabetes as
their cohorts without depression, he says.
The relationship between depression and diabetes held true even when
controlling for other risk factors, such as BMI and race. No additional risk
of diabetes was noted among people with low or intermediate levels of
depression symptoms, Jonas says.
Depression deserves more attention in the primary care setting, according
to Carrie Washburn, MPH, program director of the Oregon Diabetes Prevention
and Control Program.
Washburn presented the results of a survey showing that nearly one-third of
people with type 2 diabetes in Oregon reported symptoms of depression in the
previous 12 months, and 11% had "active symptoms consistent with major
depression" in the 2 weeks before the telephone survey.
Respondents with diabetes who were depressed were less confident in their
ability to achieve recommended levels of physical activity and less likely to
engage in regular strenuous physical activity than people without depression,
she says.
"Depression significantly impacts a person's confidence and ability
to self-manage diabetes, which is unrelated to knowledge," says
Washburn. "They know what they have to do, but are unable to comply with
therapy."
Washburn says the high incidence and impact of depression among people with
diabetes means that primary care physicians should explore this area with
patients.
"We think that screening for depression should be done more
frequently among people with diabetes," says Washburn. "Treating
depression may help patients comply with diabetes therapy." 
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