Depressive symptoms, antidepressant medication use, and new onset of diabetes in participants of the diabetes prevention program and the diabetes prevention program outcomes study
David G Marrero, Yong Ma, Mary de Groot, Edward S Horton, David W Price, Elizabeth Barrett-Connor, Mercedes R Carnethon, William C Knowler, Diabetes Prevention Program Research Group, George A Bray, Annie Chatellier, Frank L Greenway, Erma Levy, Donna H Ryan, David Ehrmann, Margaret J Matulik, Kirsten Czech, Catherine DeSandre, Barry J Goldstein, Kevin Furlong, Kellie A Smith, Wendi Wildman, Constance Pepe, Ronald B Goldberg, Jeanette Calles, Juliet Ojito, Sumaya Castillo-Florez, Hermes J Florez, Anna Giannella, Olga Lara, Beth Veciana, Steven M Haffner, Helen P Hazuda, Maria G Montez, Carlos Lorenzo, Arlene Martinez, Richard F Hamman, Dana Dabelea, Lisa Testaverde, Alexis Bouffard, Tonya Jenkins, Dione Lenz, Leigh Perreault, David W Price, Sheila C Steinke, Edward S Horton, Catherine S Poirier, Kati Swift, Enrique Caballero, Barbara Fargnoli, Ashley Guidi, Mathew Guido, Sharon D Jackson, Lori Lambert, Kathleen E Lawton, Sarah Ledbury, Jessica Sansoucy, Jeanne Spellman, Steven E Kahn, Brenda K Montgomery, Wilfred Fujimoto, Robert H Knopp, Edward W Lipkin, Anne Murillo, Dace Trence, Abbas E Kitabchi, Mary E Murphy, William B Applegate, Michael Bryer-Ash, Samuel Dagogo-Jack, Sandra L Frieson, Helen Lambeth, Lynne C Lichtermann, Hooman Otkaei, Lily M K Rutledge, Amy R Sherman, Clara M Smith, Judith E Soberman, Beverly Williams-Cleaves, Boyd E Metzger, Mark E Molitch, Mariana K Johnson, Mimi M Giles, Diane Larsen, Charlotte Niznik, Samsam C Pen, Pamela A Schinleber, David M Nathan, Mary Larkin, Charles McKitrick, Heather Turgeon, Ellen Anderson, Laurie Bissett, Kristy Bondi, Enrico Cagliero, Kali D' Anna, Linda Delahanty, Jose C Florez, Valerie Goldman, Alexandra Poulos, Elyse Raymond, Christine Stevens, Beverly Tseng, Elizabeth Barrett-Connor, Mary Lou Carrion-Petersen, Lauren N Claravall, Jonalle M Dowden, Javiva Horne, Diana Leos, Sundar Mudaliar, Jean Smith, Simona Szerdi Janisch, Karen Vejvoda, F Xavier Pi-Sunyer, Jane E Lee, Sandra T Foo, Susan Hagamen, David G Marrero, Susie M Kelly, Ronald T Ackermann, Edwin S Fineberg, Angela Hadden, Marcia A Jackson, Marion S Kirkman, Kieren J Mather, Paris J Roach, Madelyn L Wheeler, Robert E Ratner, Vanita Aroda, Sue Shapiro, Catherine Bavido-Arrage, Lilia Leon, Gabriel Uwaifo, Debra Wells-Thayer, Renee Wiggins, Mohammed F Saad, Karol Watson, Medhat Botrous, Sujata Jinagouda, Maria Budget, Claudia Conzues, Perpetua Magpuri, Kathy Ngo, Kathy Xapthalamous, Neil H White, Samia Das, Ana Santiago, Angela L Brown, Cormarie Wernimont, Christopher D Saudek, Sherita Hill Golden, Tracy Whittington, Jeanne M Clark, Alicia Greene, Dawn Jiggetts, Henry Mosley, John Reusing, Richard R Rubin, Shawne Stephens, Evonne Utsey, David S Schade, Karwyn S Adams, Claire Hemphill, Penny Hyde, Janene L Canady, Kathleen Colleran, Ysela Gonzales, Doris A Hernandez-McGinnis, Carolyn King, Jill Crandall, Janet O Brown, Elsie Adorno, Helena Duffy, Angela Goldstein, Jennifer Lukin, Helen Martinez, Dorothy Pompi, Harry Shamoon, Jonathan Scheindlin, Elizabeth A Walker, Judith Wylie-Rosett, Trevor Orchard, Andrea Kriska, Susan Jeffries, M Kaye Kramer, Marie Smith, Catherine Benchoff, Stephanie Guimond, Jessica Pettigrew, Debra Rubinstein, Linda Semler, Elizabeth Venditti, Valarie Weinzierl, Richard F Arakaki, Narleen K Baker-Ladao, Mae K Isonaga, Nina E Bermudez, Marjorie K Mau, William C Knowler, Norman Cooeyate, Mary A Hoskin, Camille Natewa, Carol A Percy, Kelly J Acton, Vickie L Andre, Shandiin Begay, Brian C Bucca, Sherron Cook, Matthew S Doughty, Justin Glass, Martia Glass, Robert L Hanson, Doug Hassenpflug, Louise E Ingraham, Kathleen M Kobus, Jonathan Krakoff, Catherine Manus, Cherie McCabe, Sara Michaels, Tina Morgan, Julie A Nelson, Robert J Roy, Miranda Smart, Darryl P Tonemah, Charlton Wilson, Sarah Fowler, Marinella Temprosa, Michael D Larsen, Tina Brenneman, Hanna Sherif, Sharon L Edelstein, Solome Abebe, Julie Bamdad, Melanie Barkalow, Joel Bethepu, Tsedenia Bezabeh, Jackie Callaghan, Costas Christophi, Nicole Butler, Mary Foulkes, Yuping Gao, Robert Gooding, Adrienne Gottlieb, Nisha Grover, Heather Hoffman, Kathleen Jablonski, Richard Katz, Preethy Kolinjivadi, John M Lachin, Yong Ma, Qing Pan, Susan Reamer, Alla Sapozhnikova, Elizabeth M Venditti, Andrea M Kriska, Linda Semler, Valarie Weinzierl, Santica Marcovina, Greg Strylewicz, John Albers, David G Marrero, Yong Ma, Mary de Groot, Edward S Horton, David W Price, Elizabeth Barrett-Connor, Mercedes R Carnethon, William C Knowler, Diabetes Prevention Program Research Group, George A Bray, Annie Chatellier, Frank L Greenway, Erma Levy, Donna H Ryan, David Ehrmann, Margaret J Matulik, Kirsten Czech, Catherine DeSandre, Barry J Goldstein, Kevin Furlong, Kellie A Smith, Wendi Wildman, Constance Pepe, Ronald B Goldberg, Jeanette Calles, Juliet Ojito, Sumaya Castillo-Florez, Hermes J Florez, Anna Giannella, Olga Lara, Beth Veciana, Steven M Haffner, Helen P Hazuda, Maria G Montez, Carlos Lorenzo, Arlene Martinez, Richard F Hamman, Dana Dabelea, Lisa Testaverde, Alexis Bouffard, Tonya Jenkins, Dione Lenz, Leigh Perreault, David W Price, Sheila C Steinke, Edward S Horton, Catherine S Poirier, Kati Swift, Enrique Caballero, Barbara Fargnoli, Ashley Guidi, Mathew Guido, Sharon D Jackson, Lori Lambert, Kathleen E Lawton, Sarah Ledbury, Jessica Sansoucy, Jeanne Spellman, Steven E Kahn, Brenda K Montgomery, Wilfred Fujimoto, Robert H Knopp, Edward W Lipkin, Anne Murillo, Dace Trence, Abbas E Kitabchi, Mary E Murphy, William B Applegate, Michael Bryer-Ash, Samuel Dagogo-Jack, Sandra L Frieson, Helen Lambeth, Lynne C Lichtermann, Hooman Otkaei, Lily M K Rutledge, Amy R Sherman, Clara M Smith, Judith E Soberman, Beverly Williams-Cleaves, Boyd E Metzger, Mark E Molitch, Mariana K Johnson, Mimi M Giles, Diane Larsen, Charlotte Niznik, Samsam C Pen, Pamela A Schinleber, David M Nathan, Mary Larkin, Charles McKitrick, Heather Turgeon, Ellen Anderson, Laurie Bissett, Kristy Bondi, Enrico Cagliero, Kali D' Anna, Linda Delahanty, Jose C Florez, Valerie Goldman, Alexandra Poulos, Elyse Raymond, Christine Stevens, Beverly Tseng, Elizabeth Barrett-Connor, Mary Lou Carrion-Petersen, Lauren N Claravall, Jonalle M Dowden, Javiva Horne, Diana Leos, Sundar Mudaliar, Jean Smith, Simona Szerdi Janisch, Karen Vejvoda, F Xavier Pi-Sunyer, Jane E Lee, Sandra T Foo, Susan Hagamen, David G Marrero, Susie M Kelly, Ronald T Ackermann, Edwin S Fineberg, Angela Hadden, Marcia A Jackson, Marion S Kirkman, Kieren J Mather, Paris J Roach, Madelyn L Wheeler, Robert E Ratner, Vanita Aroda, Sue Shapiro, Catherine Bavido-Arrage, Lilia Leon, Gabriel Uwaifo, Debra Wells-Thayer, Renee Wiggins, Mohammed F Saad, Karol Watson, Medhat Botrous, Sujata Jinagouda, Maria Budget, Claudia Conzues, Perpetua Magpuri, Kathy Ngo, Kathy Xapthalamous, Neil H White, Samia Das, Ana Santiago, Angela L Brown, Cormarie Wernimont, Christopher D Saudek, Sherita Hill Golden, Tracy Whittington, Jeanne M Clark, Alicia Greene, Dawn Jiggetts, Henry Mosley, John Reusing, Richard R Rubin, Shawne Stephens, Evonne Utsey, David S Schade, Karwyn S Adams, Claire Hemphill, Penny Hyde, Janene L Canady, Kathleen Colleran, Ysela Gonzales, Doris A Hernandez-McGinnis, Carolyn King, Jill Crandall, Janet O Brown, Elsie Adorno, Helena Duffy, Angela Goldstein, Jennifer Lukin, Helen Martinez, Dorothy Pompi, Harry Shamoon, Jonathan Scheindlin, Elizabeth A Walker, Judith Wylie-Rosett, Trevor Orchard, Andrea Kriska, Susan Jeffries, M Kaye Kramer, Marie Smith, Catherine Benchoff, Stephanie Guimond, Jessica Pettigrew, Debra Rubinstein, Linda Semler, Elizabeth Venditti, Valarie Weinzierl, Richard F Arakaki, Narleen K Baker-Ladao, Mae K Isonaga, Nina E Bermudez, Marjorie K Mau, William C Knowler, Norman Cooeyate, Mary A Hoskin, Camille Natewa, Carol A Percy, Kelly J Acton, Vickie L Andre, Shandiin Begay, Brian C Bucca, Sherron Cook, Matthew S Doughty, Justin Glass, Martia Glass, Robert L Hanson, Doug Hassenpflug, Louise E Ingraham, Kathleen M Kobus, Jonathan Krakoff, Catherine Manus, Cherie McCabe, Sara Michaels, Tina Morgan, Julie A Nelson, Robert J Roy, Miranda Smart, Darryl P Tonemah, Charlton Wilson, Sarah Fowler, Marinella Temprosa, Michael D Larsen, Tina Brenneman, Hanna Sherif, Sharon L Edelstein, Solome Abebe, Julie Bamdad, Melanie Barkalow, Joel Bethepu, Tsedenia Bezabeh, Jackie Callaghan, Costas Christophi, Nicole Butler, Mary Foulkes, Yuping Gao, Robert Gooding, Adrienne Gottlieb, Nisha Grover, Heather Hoffman, Kathleen Jablonski, Richard Katz, Preethy Kolinjivadi, John M Lachin, Yong Ma, Qing Pan, Susan Reamer, Alla Sapozhnikova, Elizabeth M Venditti, Andrea M Kriska, Linda Semler, Valarie Weinzierl, Santica Marcovina, Greg Strylewicz, John Albers
Abstract
Objective: To assess in the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study whether diagnosis of diabetes predicted elevated depressive symptoms (DS) or use of antidepressant medicine (ADM) following diagnosis; whether diabetes status or duration had significant effect on DS or ADM use; and to determine the associations between A1C, fasting plasma glucose (FPG), normalization of FPG, and DS or ADM use after diagnosis.
Methods: Diabetes Prevention Program participants in three treatment arms (intensive life style, metformin, placebo) were assessed for diabetes, glucose control, ADM use, and DS, measured using the Beck Depression Inventory (BDI). Among 3234 participants, 1285 developed diabetes. Depression levels were measured before and after diabetes diagnosis.
Results: Neither DS nor use of ADM increased after diagnosis; higher FPG was associated with greater ADM use in the intensive life style arm; a 10-mg/dl rise in FPG is associated with greater odds of ADM use. Higher FPG and A1C were associated with higher BDI scores in all three arms; A 10-mg/dl rise in FPG had a 0.07 increase in BDI. A 1% higher A1c was associated with a 0.21-point increase in BDI. Normalization of FPG was associated with lower BDI. When FPG had normalized, there was a decrease of 0.30 points in the BDI score compared when FPG had not normalized.
Conclusions: Contrary to clinical attributions, diabetes diagnosis did not show an immediate impact on BDI scores or ADM use. Higher glucose levels after diagnosis were associated with a small but significantly higher BDI score and more ADM use.
Trial registration: DPPOS: NCT00038727; DPP: NCT00004992.
Conflict of interest statement
Conflicts of Interest: The authors have no relevant conflicts of interest to disclose.
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Source: PubMed