Diabetes and depression: Global perspectives

Introduction:  This literature review was done to examine comorbid depression in people with diabetes.  They are both highly prevalent conditions, and they both greatly impact health outcomes.  In this study, the authors reviewed literature on the prevalence, burden of illness, morbidity, mortality, and cost of comorbid depression in people with diabetes.  They also looked at literature on effective treatments for cormorbid depression.

Methods:  A Medline search was performed for the years 1966 to 2009.  Those studies included addressed the association between diabetes and depression.  To analyze the literature, the authors did a qualitative aggregation; they chose not to do a formal meta-analysis because such a wide range of subjects was covered by the studies.

Results:  Comorbid depression in people with diabetes is associated with:

Conclusions:  The authors’ review of literature on diabetes and depression showed that cormorbid depression in people with diabetes leads to a significant increase in morbidity, mortality, and healthcare costs.  In order to improve clinical outcome and reduce the burden of both illnesses, it is necessary to improve coordinated care in the clinical setting.

Commentary by Leonard E. Egede MD, MS

This systematic review of articles published from 1966–2009, evaluated the global burden of diabetes, the global burden of depression and the global impact of coexisting depression on diabetes outcomes. Overall prevalence of depression in people with diabetes ranged from 11% for major depression to 31% for clinically relevant depression. The authors found consistent and strong associations between depression and poor diabetes outcomes including: poor treatment adherence, poor glycemic control, increased risk of complications, increased health care use and cost, increased disability burden, lost productivity and increased risk of death. This review summarizes the current body of knowledge in the area of diabetes and depression and emphasizes the importance of recognizing and treating depression in people with diabetes.