Diabetes and Depression Are Double Trouble for Heart
People with type 2 diabetes and depression are more likely to die after a heart attack than those without these conditions, and the increased risk is more than would be expected from each illness separately.
Association of Coexisting Diabetes and Depression With Mortality After Myocardial Infarction, by Mariska Bot and colleagues. Diabetes Care 35:503–509, 2012
What is the problem and what is known about it so far?
People with diabetes are around twice as likely to have depression as those without the disease. Diabetes and depression both increase the risk for heart attacks and the risk that a person will die after a heart attack.
Why did the researchers do this particular study?
The researchers wanted to know whether the coexistence of diabetes and depression increases the risk of death after a heart attack beyond the risks associated with either condition alone.
Who was studied?
The researchers studied 2,704 patients in the Netherlands who had been hospitalized after a heart attack.
How was the study done?
The researchers surveyed the patients while they were in the hospital, making note of who had depression and/or diabetes. They then tracked the patients for over six years, over which time 439 of the patients died. The researchers analyzed the data to determine whether their deaths were associated with whether they had diabetes, depression, or both at the time of their hospitalization.
What did the researchers find?
Compared to people without diabetes or depression who’d had a heart attack, people with diabetes had a 38 percent increased risk of death, people with depression had a 39 percent increased risk of death, and people with both diabetes and depression had a 190 percent increased risk of death.
What were the limitations of the study?
The researchers determined whether study participants were depressed by using a questionnaire, which is less accurate than an interview. Plus, they only determined whether a person was depressed during their hospitalization, and not during the rest of their lifetime, which might skew the results. The researchers also didn’t use laboratory tests to assess diabetes in the patients, but instead relied on patient records, which may have contained incorrect information.
What are the implications of the study?
Because depression and diabetes seem to work together to worsen the outcomes for heart attack survivors, the researchers hypothesized that depression may actually make diabetes worse. This squares well with other research that has found that depressed people with diabetes have higher blood glucose levels and more complications. The researchers report that these findings should encourage doctors to screen diabetic patients for depression and depression patients for diabetes, and then take measures to treat the conditions.
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