Longitudinal associations between depression and diabetes complications: a systematic review and meta-analysis

Article

Nouwen, A., Adriaanse, M., van Dam, K., Iversen, M., Viechtbauer, W., Peyrot, M., Caramlau, I., Kokoszka, A., Kanc, K., de Groot, M., Nefs, G. and Pouwer, F. 2019. Longitudinal associations between depression and diabetes complications: a systematic review and meta-analysis. Diabetic Medicine. 36 (12), pp. 1562-1572. https://doi.org/10.1111/dme.14054
TypeArticle
TitleLongitudinal associations between depression and diabetes complications: a systematic review and meta-analysis
AuthorsNouwen, A., Adriaanse, M., van Dam, K., Iversen, M., Viechtbauer, W., Peyrot, M., Caramlau, I., Kokoszka, A., Kanc, K., de Groot, M., Nefs, G. and Pouwer, F.
Abstract

Aims. To conduct a systematic review and meta-analysis of longitudinal studies assessing the bi- directional association between depression and diabetes macrovascular and microvascular complications.
Methods. Embase, Medline, and PsycINFO databases were searched from inception through 27th November 2017. A total of 4,592 abstracts were screened for eligibility. Meta-analyses used multilevel random/mixed-effects models. Quality was assessed using the Newcastle-Ottawa scale.
Results. 22 studies were included in the systematic review. 16 studies examined the relationship between baseline depression and incident diabetes complications, of which nine studies involving over 1 million participants were suitable for meta-analysis. Depression was associated with an increased risk for incident macrovascular (Hazard Ratio HR=1.38; 95%CI: 1.30-1.47) and microvascular disease (HR=1.33; 95%CI: 1.25-1.41). Six studies examined the association between baseline diabetes complications and subsequent depression, of which two involving over 230 000 participants were suitable for meta-analysis. The results showed that diabetes complications increased the risk of incident depressive disorder (HR=1.14; 95%CI: 1.07-1.21). The quality analysis showed increased risk of bias notably in the representativeness of selected cohorts and ascertainment of exposure and outcome.
Conclusions. Depression in people with diabetes is associated with an increased risk of incident macrovascular and microvascular complications. The relationship between depression and diabetes complications appears bi-directional. However, the risk of developing diabetes complications in depressed people is higher than the risk of developing depression in people with diabetes complications. The underlying mechanisms warrant further research.

Research GroupApplied Health Psychology group
PublisherWiley
JournalDiabetic Medicine
ISSN0742-3071
Electronic1464-5491
Publication dates
Online31 Jul 2019
Print13 Nov 2019
Publication process dates
Deposited05 Jul 2019
Accepted17 Jun 2019
Output statusPublished
Accepted author manuscript
Copyright Statement

This is the peer reviewed version of the following article: A. Nouwen M. C. Adriaanse K. van Dam M. M. Iversen W. Viechtbauer M. Peyrot I. Caramlau A. Kokoszka K. Kanc M. de Groot G. Nefs F. Pouwer, Longitudinal associations between depression and diabetes complications: a systematic review and meta‐analysis. Diabet. Med. 36: 1562–1572 (2019), which has been published in final form at https://doi.org/10.1111/dme.14054 .
This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.

Digital Object Identifier (DOI)https://doi.org/10.1111/dme.14054
Web of Science identifierWOS:000478742800001
LanguageEnglish
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