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High Bodyweight Variability Increases Depression Risk in Patients With Type 2 Diabetes Mellitus: A Nationwide Cohort Study in Korea.

ABSTRACT: Objectives: Although obesity is associated with increased risk for depression in patients with type 2 diabetes mellitus (DM), the relationship between body weight variability (BWV) and depression remains poorly studied. This study was to investigate the incidence of depression in patients with type 2 DM according to their BWV. Methods: Intraindividual variation in body weight were measured in the nationwide, population-based retrospective cohort of 540,293 patients with type 2 DM from the Korean national health insurance system between 2009 and 2010. The diagnoses of new-onset depression occurring until the end of 2017 were ascertained. Risk of new-onset depression was examined using multivariate-adjusted Cox proportional hazards regression analysis by BWV quartile. Results: 93,149 (17.2%) patients developed new-onset depression for the follow up. BWV was significantly associated with an increased risk of depression after adjusting for confounding factors. The highest BWV quartile group had a hazard ratio (HR) of 1.17 (95% CI 1.15-1.19) compared to the lowest BWV quartile group as a reference. Obese patients in the highest BWV quartile group showed 12% increased risk of depression (HR 1.12, 95% CI 1.09-1.15) while non-obese patients in the highest BWV quartile group showed 20% increased risk of depression (HR: 1.20, 95% CI: 1.17-1.23) compared to their respective lowest BWV quartile groups. Conclusion: A higher BWV was significantly associated with an increased risk of depression in patients with type 2 DM. Thus, BWV may serve as an indicator for early detection of depression in type 2 DM patients.

SUBMITTER: An JH

PROVIDER: S-EPMC8702997 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:This study investigated trends in the prescription of antidiabetic medications for patients with type 2 diabetes, focusing on changing patterns of prescriptions and the cost of drugs during the last 10 years. Retrospective data on patients with type 2 diabetes aged 30 years or older were analyzed using information from the National Health Information Database collected by the National Health Insurance Service in Korea from January 2002 to December 2013. We identified patients with type 2 diabetes who had at least one service claim in each year during the study period. The prescribing information was collected and fixed-dose combination tablets were counted as each of their constituent classes. The total number of adults with type 2 diabetes who were treated using antidiabetic agents increased from 0.87 million in 2002 to 2.72 million in 2013 in Korea. Among antidiabetic medications in 2002, sulfonylurea (SU) was the most commonly used agent (87.2%), and metformin was the second (52.9%). However, in 2013, the use of metformin increased to 80.4% of the total antidiabetic prescriptions. The use of dipeptidyl peptidase-4 (DPP-4) inhibitor increased remarkably after release in late 2008 and composed one-third of the market share with 1 million prescriptions (38.4%) in 2013. Among the prescriptions for monotherapy, only 13.0% were metformin in 2002, but the amount increased to 53.2% by 2013. In contrast, the use of SU declined dramatically from 75.2% in 2002 to 30.6% in 2013. Dual and triple combinations steadily increased from 35.0% and 6.6% in 2002 to 44.9% and 15.5% in 2013, respectively. In 2013, SU with metformin (41.7%) and metformin with DPP-4 inhibitor (32.5%) combination were most frequently prescribed. The total antidiabetic medication cost increased explosively from U.S. $70 million (82.5 billion won) in 2002 to U.S. $4 billion (480 billion won) in 2013.The use of antidiabetic agents and their costs have been increasing steadily. Metformin is the most commonly used drug recently. The use of DPP-4 inhibitor increased significantly over the past decade, whereas the use of SU decreased. However, SUs still remain the most commonly prescribed second-line agents with metformin in 2013.

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High Bodyweight Variability Increases Depression Risk in Patients With Type 2 Diabetes Mellitus: A Nationwide Cohort Study in Korea.

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