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Depression, anxiety and cognitive function in patients with type 2 diabetes: an 8-year prospective observational study

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Abstract

Aims

Since depression, anxiety and cognitive function may be impaired in type 2 diabetes, we investigated the relationships between clinical and socioeconomic variables and these psychological dimensions.

Methods

For an 8-year prospective observational study of 498 patients, 249 were not insulin-treated (NIT) and 249 were insulin-treated (IT). Demographic, socioeconomic and clinical data were monitored along with depression and anxiety (assessed by Zung questionnaire) and cognitive function by Mini Mental State Examination (MMSE).

Results

After 8 years, 131 patients remained NIT (NIT–NIT), 179 remained IT (IT–IT), 47 switched to insulin (NIT–IT), 111 were lost to follow-up and 30 were died. In all groups, HbA1c remained stable, BMI, glucose and lipid profile improved, and foot ulcers and retinopathy worsened. Mild worsening in depression and anxiety scores was observed in the IT–IT patients only. On multivariate analysis, worsening of depression was associated with female gender, disease duration and being IT–IT, and worsening of anxiety with disease duration. Decreased MMSE was associated inversely with smoking and directly with being IT–IT.

Conclusions

Patients with type 2 diabetes are at relatively low risk of psycho-cognitive decline. However, being female and on long-term insulin treatment may be risk factors for psychological distress, suggesting that special attention is required for these patients.

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Acknowledgments

The work described in this paper was supported by funds from Ricerca Sanitaria Finalizzata Regione Piemonte.

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Correspondence to Marina Trento.

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Conflict of interest

Marina Trento, Lorena Charrier, Martina Salassa, Stefano Merlo, Pietro Passera, Franco Cavallo, Massimo Porta declare that there is no duality of interest associated with this manuscript.

Ethical standard

The study protocol conformed to the principles of the Declaration of Helsinki.

Human and animal rights disclosure

All procedures were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

Informed consent disclosure

Informed consent was obtained from all patients for being included in the study.

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Managed by Antonio Secchi.

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Trento, M., Charrier, L., Salassa, M. et al. Depression, anxiety and cognitive function in patients with type 2 diabetes: an 8-year prospective observational study. Acta Diabetol 52, 1157–1166 (2015). https://doi.org/10.1007/s00592-015-0806-0

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  • DOI: https://doi.org/10.1007/s00592-015-0806-0

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