Depression, antidepressant use, and the risk of type 2 diabetes: a nationally representative cohort study

Hyewon Kim; You-Bin Lee; Jungkuk Lee; Dongwoo Kang; Gyuri Kim; Sang-Man Jin; Jae Hyeon Kim; Kyu Yeon Hur; Hong Jin Jeon

doi:10.3389/fpsyt.2023.1275984

Depression, antidepressant use, and the risk of type 2 diabetes: a nationally representative cohort study

Front Psychiatry. 2023 Dec 6:14:1275984. doi: 10.3389/fpsyt.2023.1275984. eCollection 2023.

Authors

Hyewon Kim¹, You-Bin Lee², Jungkuk Lee³, Dongwoo Kang³, Gyuri Kim², Sang-Man Jin², Jae Hyeon Kim², Kyu Yeon Hur^#², Hong Jin Jeon^#^{1

4}

Affiliations

¹ Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
² Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
³ Data Science Team, Hanmi Pharm. Co., Ltd., Seoul, Republic of Korea.
⁴ Department of Health Sciences and Technology, Department of Medical Device Management and Research, and Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea.

^# Contributed equally.

Abstract

Background: Previous studies have reported that depression can increase the risk of type 2 diabetes. However, they did not sufficiently consider antidepressants or comorbidity.

Methods: The National Health Insurance Sharing Service database was used. Among the sample population, 276,048 subjects who had been diagnosed with depression and prescribed antidepressants (DEP with antidepressants group) and 79,119 subjects who had been diagnosed with depression but not prescribed antidepressants (DEP without antidepressants group) were found to be eligible for this study. Healthy controls (HCs) were 1:1 matched with the DEP with antidepressants group for age and sex. We followed up with them for the occurrence of type 2 diabetes.

Results: In the group of DEP with antidepressants, although the risk of type 2 diabetes increased compared to HCs in a crude analysis, it decreased when comorbidity was adjusted for. In the group of DEP without antidepressants, the risk of type 2 diabetes decreased both in the crude model and the adjusted models. The risk varied by age group and classes or ingredients of antidepressants, with young adult patients showing an increased risk even in the fully adjusted model.

Conclusion: Overall, those with depression had a reduced risk of type 2 diabetes. However, the risk varied according to the age at onset, comorbidity, and type of antidepressants.

Keywords: antidepressants; depression; diabetes mellitus; risk factors; type 2 diabetes.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This research was supported by the Bio & Medical Technology Development Program of the National Research Foundation (NRF) funded by the Ministry of Science & ICT (no. 2021M3A9E4080784) and by the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), sponsored by the Ministry of Health & Welfare, Republic of Korea (no. HR21C0885).