Women with diabetes, depression more likely to die from heart disease

Depression is a common condition among patients with diabetes, occurring at twice the rate among those with diabetes than among healthy patients and more than doubling the risk for death among women with these conditions, according to a report in the Jan. issue of Archives of General Psychiatry.

“It is generally suggested that depression is associated with poor glycemic control, an increased risk of diabetes complications, poor adherence to diabetes management by patients and isolation from social networks,” Frank B. Hu, MD, PhD, of the departments of nutrition and epidemiology at the Harvard School of Public Health and Channing Laboratory, and colleagues wrote.

The researchers analyzed morbidity rates among a cohort of 78,282 women aged 54 to 79 years who participated in the Nurses' Health Study. They compared mortality rates among women in good health and those with either a self-reported depression diagnosis, those treated with antidepressant medications or women who had a score indicating severe depression on the Mental Health Index (≤52). A total of 4,654 women died, with 979 deaths attributable to CVD.

Compared to patients without either condition, those who had both diabetes and depression had an age-adjusted relative risk of 3.11 for all-cause death. Patients with diabetes had an RR of 1.71, and those with depression had an RR of 1.76.

CVD mortality risk alone was also higher among patients with both conditions even after adjusting for confounding factors– women with both conditions had a RR of 5.38 compared to an RR of 1.81 among those with diabetes only and 2.67 for those with depression only.

“Considering the size of the population that could be affected by these two prevalent disorders, further consideration is required to design strategies aimed to provide adequate psychological management and support among those with longstanding chronic conditions, such as diabetes,” the researchers wrote.

They suggest identifying women with these coexisting conditions as particularly high risk for targeted treatment interventions.

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