Depression and poor glycemic control: a meta-analytic review of the literature.

Authors

Lustman PJ, Anderson RJ, Freedland KE, et al. 

Institution

Department of Psychiatry, Washington University School of Medicine, and the Department of Veterans Affairs Medical Center, St Louis, Missouri, USA. lustmanp@psychiatry.wustl.edu

Source

Diabetes Care 2000 Jul; 23(7) :934-42.

Abstract

OBJECTIVE
Depression is common among patients with diabetes, but its relationship to glycemic control has not been systematically reviewed. Our objective was to determine whether depression is associated with poor glycemic control.
RESEARCH DESIGN AND METHODS
Medline and PsycINFO databases and published reference lists were used to identify studies that measured the association of depression with glycemic control. Meta-analytic procedures were used to convert the findings to a common metric, calculate effect sizes (ESs), and statistically analyze the collective data.
RESULTS
A total of 24 studies satisfied the inclusion and exclusion criteria for the meta-analysis. Depression was significantly associated with hyperglycemia (Z = 5.4, P < 0.0001). The standardized ES was in the small-to-moderate range (0.17) and was consistent, as the 95% CI was narrow (0.13-0.21). The ES was similar in studies of either type 1 or type 2 diabetes (ES 0.19 vs. 0.16) and larger when standardized interviews and diagnostic criteria rather than self-report questionnaires were used to assess depression (ES 0.28 vs. 0.15).
CONCLUSIONS
Depression is associated with hyperglycemia in patients with type 1 or type 2 diabetes. Additional studies are needed to establish the directional nature of this relationship and to determine the effects of depression treatment on glycemic control and the long-term course of diabetes.

Mesh

Adult
Blood Glucose
Databases, Factual
Depression
Diabetes Mellitus, Type 1
Diabetes Mellitus, Type 2
Humans
MEDLINE

Language

eng

Pub Type(s)

Journal Article Meta-Analysis Research Support, U.S. Gov't, P.H.S.

PubMed ID

10895843