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The affective and somatic side of depression: subtypes of depressive symptoms show diametrically opposed associations with glycemic control in people with type 1 diabetes

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Abstract

Aims

While depression has been linked to serious adverse outcomes in diabetes, associations with glycemic control are not conclusive. Inconsistencies could be due to the complex symptomatology of depression. Aim of this study was to analyze the associations of depressive subtypes with glycemic control in people with type 1 and type 2 diabetes.

Methods

Patients completed the Center for Epidemiological Studies-Depression scale which comprises affective, somatic, and anhedonic symptoms. These subtypes were analyzed in a joint linear regression analysis with glycemic control as a dependent variable. Subtype scores were calculated as mean item scores. Separate analyses for people with type 1 and type 2 diabetes were conducted. All analyses were controlled for demographic and medical confounders.

Results

The sample comprised 604 patients with type 1 and 382 patients with type 2 diabetes. In people with type 1 diabetes, the somatic and affective subtype showed diametrically opposed associations with glycemic control (somatic: β =+0.23, p < .05; affective: β = −0.23, p < .05). Anhedonia was not significantly associated with glycemic control. In people with type 2 diabetes, none of the depressive subtypes was significantly associated with glycemic control.

Conclusions

For people with type 1 diabetes, the distinction of subtypes offered a detailed picture of the associations of depressive symptoms with glycemic control. However, due to the cross-sectional design, inferences about the direction of these associations cannot be made. In clinical practice, instead of focusing on overall depression, healthcare providers should examine the nature of depressive symptoms and how they might be related to having diabetes.

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Authors’ contribution

DE and NH researched the data and wrote the manuscript. AS and AR contributed to the discussion and reviewed/edited the manuscript. TH and BK contributed to the discussion. DE is the guarantor of the article, therefore taking full responsibility for the contents of the article.

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Correspondence to Dominic Ehrmann.

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The authors declare that they have no conflict of interest.

Ethical standard

As this was a retrospective analysis, formal consent is not required. The three studies which were combined for this analysis were in accordance with the ethical standards of the national research committee and with the 1964 Helsinki declaration and its later amendments.

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Informed consent was obtained from all individual participants included in the study.

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Managed by Massimo Federici.

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Ehrmann, D., Schmitt, A., Reimer, A. et al. The affective and somatic side of depression: subtypes of depressive symptoms show diametrically opposed associations with glycemic control in people with type 1 diabetes. Acta Diabetol 54, 749–756 (2017). https://doi.org/10.1007/s00592-017-1006-x

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  • DOI: https://doi.org/10.1007/s00592-017-1006-x

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