Prediabetes and the risk of type 2 diabetes: investigating the roles of depressive and anxiety symptoms in the Lifelines cohort study

Article

Deschênes, S., McInerney, A., Nearchou, F., Byrne, B., Nouwen, A. and Schmitz, N. 2023. Prediabetes and the risk of type 2 diabetes: investigating the roles of depressive and anxiety symptoms in the Lifelines cohort study. Diabetic Medicine. 40 (7). https://doi.org/10.1111/dme.15061
TypeArticle
TitlePrediabetes and the risk of type 2 diabetes: investigating the roles of depressive and anxiety symptoms in the Lifelines cohort study
AuthorsDeschênes, S., McInerney, A., Nearchou, F., Byrne, B., Nouwen, A. and Schmitz, N.
Abstract

Background
Depression and anxiety may increase the risk of progressing from prediabetes to type 2 diabetes. The present study examined the interactions between prediabetes status and elevated depressive and anxiety symptoms with the risk of type 2 diabetes.
Methods
Participants (N=72,428) were adults aged 40 years and above without diabetes at baseline from the Lifelines Cohort Study (58% female; mean age=51.4 years). The Mini-International Neuropsychiatric Interview screened for elevated symptoms of major depressive disorder and generalized anxiety disorder. Glycated hemoglobin A1c (HbA1c) levels determined prediabetes status at baseline (2007-2013), and HbA1c and self-reported diabetes diagnoses determined diabetes status at follow-up (2014-2017). Groups were formed for elevated depressive and anxiety symptoms, respectively, and prediabetes status at baseline (elevated depressive/anxiety symptoms with prediabetes, elevated depressive/anxiety symptoms alone, and prediabetes alone), and compared to a reference group (no prediabetes or anxiety/depression) on the likelihood of developing diabetes during the follow-up period.
Findings
N=1,300 (1.8%) participants developed diabetes. While prediabetes alone was associated with incident diabetes (OR=5.94; 95% CI=5.10-6.90, p<.001), the group with combined prediabetes and depressive symptoms had the highest likelihood of developing diabetes over follow-up (OR=8.29; 95% CI=5.58-12.32, p<.001). Similar results were found for prediabetes and anxiety symptoms (OR=6.57; 95% CI=4.62-9.33, p<.001), compared to prediabetes alone (OR=6.09; 95% CI=5.23-7.11, p<.001), though with a smaller effect. The interaction between depressive symptoms and prediabetes was synergistic in age-and-sex adjusted analyses.
Conclusion
Individuals with elevated depressive, and to some extent anxiety, symptoms in combination with prediabetes may represent a high-risk subgroup for type 2 diabetes.

KeywordsEndocrinology; Endocrinology, Diabetes and Metabolism; Internal Medicine; anxiety; depression; mental health; prediabetes; prediction of diabetes
Sustainable Development Goals3 Good health and well-being
Middlesex University ThemeHealth & Wellbeing
PublisherWiley
JournalDiabetic Medicine
ISSN0742-3071
Electronic1464-5491
Publication dates
Online17 Feb 2023
Print18 Jun 2023
Publication process dates
Deposited17 Feb 2023
Submitted14 Sep 2022
Accepted01 Feb 2023
Output statusPublished
Publisher's version
License
Digital Object Identifier (DOI)https://doi.org/10.1111/dme.15061
Web of Science identifierWOS:000937534500001
LanguageEnglish
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