Depression Increases Insulin Resistance, Diabetes in Middle-Aged Women

"Patients and their providers should recognize that depressive symptoms can increase risk of diabetes and are related to higher levels of insulin resistance, which is a risk factor for diabetes."

"Patients should be encouraged to seek treatment for clinically significant depressive symptoms and to maintain or adopt active lifestyles, healthy diets, and weight loss if needed to reduce the risk of diabetes," they add.

Dr. Susan A. Everson-Rose, from Rush University Medical Center in Chicago, and associates analyzed data on depression, change in insulin resistance over 3 years, and risk of diabetes in 2,662 multiethnic women enrolled in a longitudinal study of health and aging.

They observed an association between depression and higher homeostasis model assessment of insulin resistance values (HOMA-IR) and incident diabetes.

These associations, they emphasize, are mediated largely through central adiposity. With the exception of African-American women, the link between depression and HOMA-IR values disappeared in analyses adjusting for central adiposity. Likewise, depression, which predicted a 1.66-fold greater risk of diabetes, became nonsignificant after factoring in central adiposity.
African-American women with depression were at increased risk of diabetes "independent of central adiposity and other risk factors," according to investigators.

The incidence of diabetes was highest in African-American women in the 3 years of follow-up and was more than twice that of white women. This suggests to the team that factors other than central adiposity may contribute to the excess risk of diabetes in African-American women.

Diabetes Care 2004;27:2856-2862.
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