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The association between insulin therapy and depression in patients with type 2 diabetes mellitus: a meta-analysis.

ABSTRACT: OBJECTIVES:Several patients with type 2 diabetes mellitus (T2DM) have depressive disorders. Whether insulin treatment was associated with increased risk of depression remains controversial. We performed a meta-analysis to evaluate the association of insulin therapy and depression. DESIGN:A meta-analysis. METHODS:We conducted a systematic search of PubMed, PsycINFO, Embase and the Cochrane Library from their inception to April 2016. Epidemiological studies comparing the prevalence of depression between insulin users and non-insulin users were included. A random-effects model was used for meta-analysis. The adjusted and crude data were analysed. RESULTS:Twenty-eight studies were included. Of these, 12 studies presented with adjusted ORs. Insulin therapy was significantly associated with increased risk of depression (OR=1.41, 95%?CI 1.13 to 1.76, p=0.003). Twenty-four studies provided crude data. Insulin therapy was also associated with an odds for developing depression (OR=1.59, 95%?CI 1.41 to 1.80, p<0.001). When comparing insulin therapy with oral antidiabetic drugs, significant association was observed for adjusted (OR=1.42, 95%?CI 1.08 to 1.86, p=0.008) and crude (OR=1.61, 95%?CI 1.35 to 1.93, p<0.001) data. CONCLUSIONS:Our meta-analysis confirmed that patients on insulin therapy were significantly associated with the risk of depressive symptoms.

SUBMITTER: Bai X

PROVIDER: S-EPMC6278799 | biostudies-other | 2018 Nov

REPOSITORIES: biostudies-other

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The association between insulin therapy and depression in patients with type 2 diabetes mellitus: a meta-analysis.

Bai Xiaosu X Liu Zhiming Z Li Zhisen Z Yan Dewen D

BMJ open 20181128 11

<h4>Objectives</h4>Several patients with type 2 diabetes mellitus (T2DM) have depressive disorders. Whether insulin treatment was associated with increased risk of depression remains controversial. We performed a meta-analysis to evaluate the association of insulin therapy and depression.<h4>Design</h4>A meta-analysis.<h4>Methods</h4>We conducted a systematic search of PubMed, PsycINFO, Embase and the Cochrane Library from their inception to April 2016. Epidemiological studies comparing the prev ...[more]

PMID: 30498035

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Project description:Background: Insulin-like growth factor-1 (IGF-1) has been demonstrated to increase fatty acid β oxidation during fasting, and play an important role in regulating lipid metabolism and type 2 diabetes mellitus (T2DM). The rs35767 (T > C) polymorphism, a functional SNP was found in IGF-1 promoter, which may directly affect IGF-1 expression. However, the inconsistent findings showed on the IGF-1 rs35767 polymorphism and T2DM risk. Methods: We performed a comprehensive meta-analysis to estimate the association between the IGF-1 rs35767 and T2DM risk among four genetic models (the allele, additive, recessive and dominant models). Results: A total 49,587 T2DM cases and 97,906 NDM controls were included in the allele model, a total 2256 T2DM cases and 2228 NDM controls were included in the other three genetic models (the additive; recessive and dominant models). In overall analysis, the IGF-1 rs35767 was shown to be significantly associated with increased T2DM risk for the allele model (T vs. C: OR = 1.251, 95% CI: 1.082-1.447, p = 0.002), additive model (homozygote comparisons: TT vs. CC: OR = 2.433, 95% CI: 1.095-5.405, p = 0.029; heterozygote comparisons: TC vs. CC: OR = 1.623, 95% CI: 1.055-2.495, p = 0.027) and dominant model (TT + CT vs. CC: OR = 1.934, 95% CI: 1.148-3.257, p = 0.013) with random effects model. After omitting Gouda's study could reduce the heterogeneity, especially in the recessive model (TT vs. CC + CT: I2 = 38.7%, p = 0.163), the fixed effects model for recessive effect of the T allele (TT vs. CC + CT) produce results that were of borderline statistical significance (OR = 1.206, 95% CI: 1.004-1.448, p = 0.045). And increasing the risk of T2DM in Uyghur population of subgroup for the allele model. Conclusion: The initial analyses that included all studies showed statistically significant associations between the rs35767 SNP and type 2 diabetes, but after removing the Gouda et al. study produced results that were mostly not statistically significant. Therefore, there is not enough evidence from the results of the meta-analysis to indicate that the rs35767 SNP has a statistically significant association with type 2 diabetes.

Project description:ObjectiveThe adverse effects of poor social support on quality of life and adherence to treatment are established. However, the relationship between social support and depression is not well understood. In this systematic review and meta-analysis, we aim to examine the association between social support and depressive symptoms among type 2 patients with diabetes.DesignSystematic review and meta-analysis.Data sourcesWe searched PubMed, African Journals Online, Web of Science, and the Cochrane Library electronic databases. Some studies were also identified through manual Google search and Google scholar.Eligibility criteriaWe systematically searched electronic databases for studies published up to October 2020. Only English-language articles were included.Data extraction and synthesisScreening, data extraction and quality appraisal were conducted by two independent reviewers. A random-effect model was applied to estimate ORs with 95% CIs. The Higgins I2 test was used to assess the heterogeneity between the studies. The risk of publication bias was estimated using the Egger test. Leave-one-out analysis was done. Data were analysed using Stata V.11.ResultsSeven studies were included in the meta-analysis. The findings from included studies revealed that poor social support increases the odds of depression among patients with diabetes (adjusted OR=2.14, 95% CI 1.34 to 3.43, p=0.003). There was no risk of publication bias (p=0.064), and heterogeneity was substantial (I2=70.7%). The leave-one-out analysis confirmed the consistency of the findings.ConclusionsOur meta-analysis revealed that patients who had poor social support were significantly associated with an increased level of depression. Additional studies exploring factors that might moderate or mediate this association are needed. Targeted interventions for comorbid depression should be implemented in clinical practice.Systematic review registrationWe have submitted the protocol for registration at the PROSPERO on 9 October 2020. But we have not yet received a registration number.

Project description:Background: The prevalence of type 2 diabetes has increased dramatically in recent decades. Increasing brown adipose tissue (BAT) mass and activity has recently emerged as an interesting approach to not only increase energy expenditure, but also improve glucose homeostasis. BAT can be recruited by prolonged cold exposure in lean, healthy humans. Here, we tested whether cold acclimation could have therapeutic value for patients with type 2 diabetes by improving insulin sensitivity. Methods: Eight type 2 diabetic patients (age 59.3±5.8 years, BMI 29.8±3.2 kg/m2) followed a cold acclimation protocol, consisting of intermittent cold exposure (6 hours/day, 14-14.5 °C) for 12 consecutive days. Before and after cold acclimation, cold-induced BAT activity was assessed by [18F]FDG-PET/CT scanning, insulin sensitivity at thermoneutrality by a hyperinsulinemic-euglycemic clamp, and muscle and WAT biopsies were taken. Results: Cold-induced BAT activity was low, but increased in all patients upon cold acclimation (SUV from 0.40±0.29 to 0.63±0.78, p<0.05). Interestingly, insulin sensitivity showed a very pronounced 40% increase upon cold acclimation (glucose rate of disappearance from 14.9±4.1 to 20.5±6.9 μmol kg-1 min-1, p<0.05). A 40% increase in insulin sensitivity cannot be explained by BAT glucose uptake, in fact basal skeletal muscle GLUT4 content and translocation was markedly increased after cold acclimation, without effects on insulin signaling or AMPk activation. Conclusions: Regular mild cold exposure has marked effects on insulin sensitivity, which are accompanied by small increases in BAT activity and more pronounced effects on skeletal muscle. These data suggest a novel therapeutic option for the treatment of type 2 diabetes. Microarray analysis was performed on abdominal subcutaneous white adipose tissue samples from human type 2 diabetic patients before, and after 10 days of cold acclimation. A total of 14 samples, from 7 subjects, were used for the microarray analysis.

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The association between insulin therapy and depression in patients with type 2 diabetes mellitus: a meta-analysis.

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The association between insulin therapy and depression in patients with type 2 diabetes mellitus: a meta-analysis.

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