Higher baseline HbA1c values were associated with an 18% increased risk of probable depression (OR 1.18), and higher baseline depressive symptoms were associated with subsequent higher HbA1c levels.
Meta-Analysis (n=48,793)
Is there a bidirectional longitudinal association between depressive symptoms and HbA1c levels in adults?
There is a small but significant bidirectional longitudinal association between depressive symptoms and HbA1c levels, suggesting that both could be targeted concurrently in the prevention and treatment of diabetes and depression.
Effect estimate: OR 1.18 (95% CI 1.12, 1.25)
p-value: p=<0.001
Abstract Aim To investigate whether there is a bidirectional longitudinal association of depression with HbA 1c . Methods We conducted a systematic literature search in PubMed, PsycINFO, CINAHL and EMBASE for observational, longitudinal studies published from January 2000 to September 2020, assessing the association between depression and HbA 1c in adults. We assessed study quality with the Newcastle‐Ottawa‐Scale. Pooled effect estimates were reported as partial correlation coefficients (r p ) or odds ratios (OR). Results We retrieved 1642 studies; 26 studies were included in the systematic review and eleven in the meta‐analysis. Most studies (16/26) focused on type 2 diabetes. Study quality was rated as good (n = 19), fair (n = 2) and poor (n = 5). Of the meta‐analysed studies, six investigated the longitudinal association between self‐reported depressive symptoms and HbA 1c and five the reverse longitudinal association, with a combined sample size of n = 48,793 and a mean follow‐up of 2 years. Higher levels of baseline depressive symptoms were associated with subsequent higher levels of HbA 1c (partial r = 0.07; 95% CI 0.03, 0.12; I 2 38%). Higher baseline HbA 1c values were also associated with 18% increased risk of (probable) depression (OR = 1.18; 95% CI 1.12,1.25; I 2 0.0%). Conclusions Our findings support a bidirectional longitudinal association between depressive symptoms and HbA 1c . However, the observed effect sizes were small and future research in large‐scale longitudinal studies is needed to confirm this association. Future studies should investigate the role of type of diabetes and depression, diabetes distress and diabetes self‐management behaviours. Our results may have clinical implications, as depressive symptoms and HbA 1c levels could be targeted concurrently in the prevention and treatment of diabetes and depression. Registration PROSPERO ID CRD42019147551.
Beran et al. (Wed,) conducted a meta-analysis in Diabetes mellitus and depression (n=48,793). Higher baseline HbA1c vs. Lower baseline HbA1c was evaluated on Incident (probable) depression (OR 1.18, 95% CI 1.12, 1.25, p=<0.001). Higher baseline HbA1c values were associated with an 18% increased risk of probable depression (OR 1.18), and higher baseline depressive symptoms were associated with subsequent higher HbA1c levels.