ArticleBJPsych open2025
Depressive symptoms and hypoglycaemic risk in individuals with type 2 diabetes mellitus: insights from the ACCORD-HRQL study.
Article in BJPsych open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundDepression in individuals with type 2 diabetes mellitus (T2DM) is associated with worse clinical prognosis; however, evidence regarding the relationship between depression and hypoglycaemic risk remains limited and inconclusive.
aimOur study aimed to evaluate the association between depressive symptoms and hypoglycaemic events.
methodDepressive symptoms were assessed in participants of the ACCORD-HRQL study at baseline and during follow-up visits at 12, 36 and 48 months using the nine-item Patient Health Questionnaire (PHQ-9). Symptom severity was categorised into three levels: none (0-4 points), mild (5-9 points) or moderate to severe (10-24 points). The primary outcomes included hypoglycaemia requiring any assistance (HAA) and hypoglycaemia requiring medical assistance (HMA).
resultsOver a median follow-up of 4.3 years, 220 individuals developed HAA (incidence rate: 27.0 per 1000 person-years) and 157 individuals experienced HMA (incidence rate: 18.8 per 1000 person-years). Depressive symptoms exhibited dynamic fluctuations during the study period, and participants with depression consistently demonstrated less effective glycaemic control compared to those without depression. However, each one-unit increase in PHQ-9 score was not associated with elevated risks of HAA (hazard ratio, 1.00; 95% CI, 0.97-1.03) or HMA (hazard ratio, 0.98; 95% CI, 0.95-1.02).
conclusionsDepressive symptoms in individuals with T2DM are dynamic and correlate with suboptimal glycaemic control. However, no significant association was observed between depression severity and increased hypoglycaemic events. These findings highlight the importance of integrated clinical strategies for continuous mental health monitoring and glucose management in T2DM individuals.
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