King's College London

Academic Institute

Khalida Ismail - Chief Investigator - King's College LondonAlex Dregan - Corresponding Applicant - King's College Londonmana rahimzadeh - Collaborator - King's College London

CPRD876

Depression, is a common problem in people with type 2 diabetes. Depression is linked to worse outcomes such as diabetes complications and early mortality. The reasons for these negative outcomes are not clear. One possible explanation is that when a person depression has depression, they lose interest, motivation and energy to look after themselves and this includes their diabetes. If this occurs, it can lead to worsening blood glucose control. This is medically important as depression can be treated with antidepressants and/or talking therapies. There have been many studies looking at the link between depression and blood glucose (also sometimes described as sugar) control. Most of these studies measure depression and blood glucose levels at the same time point so it is impossible to find out if it is depression leading to the high blood glucose or the other way round. There have been only a handful of studies examining whether depression leads to poor blood glucose levels over time such several months or several years later. The few studies that have examined this link have not found conclusive results. Therefore, we would like to study whether depression leads to worsening blood glucose levels over time using anonymised general practice (GP) medical records.

The prevalence of depression is twice as common in T2D than the general population and is associated with worse outcomes such as increased rates of diabetes complications and premature mortality. There is a bilateral relationship between depression and type 2 diabetes (T2D); Depression is associated with an approximately 60% increased risk of developing T2D, and T2D is associated with an approximately 20% increased risk of incident depressive symptoms. Despite these associations, the reasons for the adverse effects of depressive symptoms in T2DM are incompletely understood. One of the most common reasons given is the psychological model, namely that depressive symptoms, such as low mood and anhedonia (loss of pleasure in everyday activities) lead to neglect of diabetes self management and thus worse glycaemic control. There have been many cross-sectional studies that repeatedly report an association between depression and worse glycaemic control, there have been fewer prospective studies and these have not consistently observed the same association. Prospective studies have been limited by short duration of follow up and selective sampling. The clinical importance is that depression is relatively easy to screen and diagnosis and is a potentially modifiable target. The main aim is to conduct a secondary analysis of a big primary care cohort to test the hypothesis that depression is associated with worsening glycaemic control over a 10 year follow up period adjusting for relevant confounding.

02/02/2021

Release