Lower HbA1C of glycemic control is associated with higher risk of depressive symptoms in elderly with type 2 diabetes mellitus-A Nationwide Community-based study

Yen-Tze Liu; Wan-Hui Wu; Wei-Ting Tseng; Hsien-Chih Lin; Ming-Shiang Wu; Pei-Fen Chen; I-Chien Wu

doi:10.1016/j.jpsychores.2023.111492

Lower HbA1C of glycemic control is associated with higher risk of depressive symptoms in elderly with type 2 diabetes mellitus-A Nationwide Community-based study

J Psychosom Res. 2023 Nov:174:111492. doi: 10.1016/j.jpsychores.2023.111492. Epub 2023 Sep 9.

Authors

Yen-Tze Liu¹, Wan-Hui Wu², Wei-Ting Tseng³, Hsien-Chih Lin³, Ming-Shiang Wu⁴, Pei-Fen Chen³, I-Chien Wu⁵

Affiliations

¹ Department of Family Medicine, Changhua Christian Hospital, Changhua, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan; Big Data Center, Changhua Christian Hospital, Changhua, Taiwan. Electronic address: 144084@cch.org.tw.
² Department of Family Medicine, Changhua Christian Hospital, Changhua, Taiwan.
³ Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan.
⁴ National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan, Taiwan.
⁵ Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan; Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan.

PMID: 37708592
DOI: 10.1016/j.jpsychores.2023.111492

Abstract

Objective: We investigated the correlation between glycemic control status and depressive symptoms in type 2 diabetes elderly.

Methods: A total of 1527 participants with type 2 diabetes aged 55 years and older from the Healthy Aging Longitudinal Study in Taiwan study were included in this cross-sectional study. The Center for Epidemiologic Studies Depression Scale (CESD) (20 items) score of ≥16 was indicative of depressive symptoms. The participants were divided into HbA1c ≥ 6.5% and < 6.5% representing the glycemic control. Multiple logistic regression (MLR) and Generalized linear model (GLM) were used.

Results: The MLR analysis showed that the low HbA1c group had significant two-fold increased odds of depressive symptoms compared to the high HbA1c group (OR 1.89, 95% CI 1.17-3.05). The risk of depressive symptoms was lower among males (OR 0.49, 95% CI 0.30-0.80) and those with higher BMI (OR 0.93, 95% CI 0.86-1.00); whereas the risk was higher among those who lived alone (OR 2.37, 95% CI 1.31-4.27) and with ADL disability (OR 3.01, 95% CI 1.85-4.89). The GLM showed that the dimension of depressive affect reached statistical significance with lower HbA1c.

Conclusion: This nationwide community-based study shows that depressive symptoms are associated with lower HbA1C, reminding us that more attention should be paid to the presence of depressive symptoms in those with lower HbA1C. Further research is needed to clarify the causal relationship.

Keywords: Depressive symptoms; Glycemic control; HALST study; Nationwide community-based study; Type 2 diabetes.