National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
Steno Diabetes Center Sjaelland, Holbaek, Denmark.
Diabet Med. 2024 Apr;41(4):e15272. doi: 10.1111/dme.15272. Epub 2023 Dec 29.
To investigate if diabetic complications increase the risk of depression and/or anxiety among adults with type 2 diabetes.
This register-based, prospective study included 265,799 adult individuals diagnosed with type 2 diabetes between 1997 and 2017 without a recent history of depression or anxiety. Diabetic complications included cardiovascular disease, amputation of lower extremities, neuropathy, nephropathy and retinopathy. Both diabetic complications and depression and anxiety were defined by hospital contacts and prescription-based medication. All individuals were followed from the date of type 2 diabetes diagnosis until the date of incident depression or anxiety, emigration, death or 31 December 2018, whichever occurred first.
The total risk time was 1,915,390 person-years. The incidence rate of depression and/or anxiety was 3368 per 100,000 person-years among individuals with diabetic complications and 1929 per 100,000 person-years among those without. Having or developing any diabetic complication was associated with an increased risk of depression and/or anxiety (HR 1.77, 95% CI 1.73-1.80). The risk for depression and/or anxiety was increased for all types of diabetic complications. The strongest association was found for amputation of lower extremities (HR 2.16, 95% CI 2.01-2.31) and the weakest for retinopathy (HR 1.13, 95% CI 1.09-1.17).
Individuals with type 2 diabetes and diabetic complications are at increased risk of depression and anxiety. This points towards the importance of an increased clinical focus on mental well-being among individuals with type 2 diabetes and complications.
研究 2 型糖尿病患者的糖尿病并发症是否会增加其患抑郁症和/或焦虑症的风险。
本基于登记的前瞻性研究纳入了 1997 年至 2017 年间无近期抑郁或焦虑病史的 265799 例成年 2 型糖尿病患者。糖尿病并发症包括心血管疾病、下肢截肢、周围神经病变、肾病和视网膜病变。糖尿病并发症和抑郁及焦虑均通过医院就诊记录和处方药物来定义。所有患者均从 2 型糖尿病诊断日期开始随访，直至出现抑郁或焦虑、移民、死亡或 2018 年 12 月 31 日（以先发生者为准）。
总随访时间为 1915390 人年。有糖尿病并发症患者的抑郁和/或焦虑发生率为 3368/100000 人年，无糖尿病并发症患者的发生率为 1929/100000 人年。患有或新发任何一种糖尿病并发症与抑郁和/或焦虑风险增加相关（HR 1.77，95%CI 1.73-1.80）。所有类型的糖尿病并发症均会增加发生抑郁和/或焦虑的风险，其中下肢截肢的相关性最强（HR 2.16，95%CI 2.01-2.31），视网膜病变的相关性最弱（HR 1.13，95%CI 1.09-1.17）。
2 型糖尿病合并糖尿病并发症患者发生抑郁和焦虑的风险增加。这表明在 2 型糖尿病患者和并发症患者中，更应关注其心理健康。
