Antidepressant Use and Glycemic Control in Diabetic Population: A Meta-analysis.

BACKGROUND

Depression is prevalent in the diabetic population. Primary care physician is busy in treating diabetes and depression among them goes unnoticed. According to the American Diabetic Association, two out of three are not able to achieve glycaemic control. Diabetes and depression both share complex cause-effect relationship.

OBJECTIVES

To evaluate the effect of antidepressants on glycaemic control among the adult diabetic population suffering from depression.

METHOD

Cochrane database was systematically searched with search strategy andonly parallel randomized clinical trial with antidepressant and placebo group were considered. Outcome measures were HbA1c, Fasting blood glucose, weight, body mass index, treatment adherence. Data extraction form were adapted from Cochrane. Two researchers identified studies and extracted data independently. Revman was used for meta-analysis and risk of bias. Level of evidence was generated using Gradepro.

RESULTS

Out of 394 studies, six studies fulfilling the eligibility criteria were pooled for analysis. Using mean difference (MD), meta-analysis showed significant evidence of glycaemic control in favor of antidepressant treated diabetic population compared to placebo group (n = 6 studies) (MD = - 0.32%; 95% CI = - 0.57 to 0.08). Weight, BMI does not show a any significant mean difference between two groups.

CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS

There is moderate level of evidence that antidepressants improve the glycaemic control in diabetic population suffering from depression. Understanding and treating the mental and psychological determinant with adequate control of depression should be emphasized for the diabetic population.