Seven-Fold Increase in Depressive Symptoms Among Men with Type 1 Diabetes Signals Need for Intervention: Study

"Elevated depressive symptoms were also associated with poorer diabetes self-management and reduced physical activity, emphasizing the importance of routine depression screening for men with type 1 diabetes," the researchers wrote in Diabetes Research and Clinical Practice.

The researchers note that depression is more prevalent in diabetes, with 9–17.5% of adults with type 1 diabetes reporting elevated symptoms. Limited studies highlight sex differences, with higher rates in women. Depression negatively impacts insulin use, glucose monitoring, physical activity, and HDL, while increasing HbA1c, BMI, cholesterol, and cardiovascular complications in type 1 diabetes.

Against the above background, Kimberly A. Driscoll, University of Florida Diabetes Institute, University of Florida, Gainesville, FL, United States, and colleagues aimed to examine differences in the prevalence of elevated depressive symptoms between individuals with type 1 diabetes and those without diabetes, both overall and by sex, as well as the associations between depressive symptoms, HbA1c levels, self-management behaviors, and cardiovascular health.

For this purpose, the researchers analyzed data from adults with type 1 diabetes (n = 414; mean age 52 ± 9 years, diabetes duration 38 ± 9 years, mean HbA1c 7.8 ± 1.1 mg/dL, 55% female) and without diabetes (n = 488; mean age 51 ± 9 years, 51% female) from the fourth visit of the CACTI observational study.

Participants completed questionnaires on depressive symptoms and dietary intake, with those having type 1 diabetes also reporting on self-management behaviors. Hierarchical logistic regression models were used to identify demographic and clinical factors associated with depressive symptoms.

The following were the key findings of the study:

• Depressive scores were higher in individuals with type 1 diabetes compared to those without diabetes, overall and across both sexes.
• Men with type 1 diabetes had more than sevenfold increased odds of elevated depressive symptoms compared to men without diabetes (OR 7.4).
• There was no significant increase in odds for women with type 1 diabetes compared to those without diabetes (OR 1.4).
• There was a significant interaction between sex and diabetes status.
• Higher depressive symptoms were linked to lower engagement in self-management behaviors and reduced physical activity.

The researchers report that 10% of adults with type 1 diabetes experience depressive symptoms based on BDI-II assessments.

"There is an urgent need to incorporate routine screening for depressive symptoms in adults with type 1 diabetes as part of standard medical care and to explore interventions aimed at reducing their impact on diabetes outcomes," the researchers concluded.

Reference:

Driscoll, K. A., Geno Rasmussen, C. R., O’Donnell, H., Trojanowski, P., Alman, A. C., Keshawarz, A., & Snell-Bergeon, J. K. (2024). Men with type 1 diabetes had more than 7-fold odds of elevated depressive symptoms compared to men without diabetes. Diabetes Research and Clinical Practice, 111947. https://doi.org/10.1016/j.diabres.2024.111947