Depression + diabetes = higher heart risks for women
January 3rd, 2011
04:00 PM ET

Depression + diabetes = higher heart risks for women

Women who suffer from both depression and diabetes have a increased risk of dying from heart disease, as well as having a higher chance of dying over a six-year period, according to a new study out this week.

Researchers who published the data in the Archives of General Psychiatry looked at more than 78,000 women between the ages of 54 and 79 who were participating in the famous Nurse's Health Study.

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The women were labeled as being depressed if they reported getting a diagnosis and treatment for the condition or scored high on a test that measured symptoms of depression. Reports of type 2 diabetes were noted in questionnaire, filled out by participants

Researchers than followed up on these subjects six years later and found 4,654 of the women had died, including 979 who died from cardiovascular disease. Investigators discovered that women with depression had a 44% increased risk of death compared with women who did not have diagnosed depression. When it came to diabetes, those who had the condition had a 35% increased risk of death over those who did not have the illness. And women with both conditions had approximately twice the risk of death of those who had neither condition.

When looking only at deaths from cardiovascular disease, women with diabetes had a 67% increased risk, women with depression had a 37% increased risk and women with both had almost a threefold increased risk.

"It is generally suggested that depression is associated with poor glycemic control, an increased risk of diabetes complications, poor adherence to diabetes management by patients and isolation from the social network," noted study author, An Pan, Ph.D., of the Harvard School of Public Health in Boston. Investigators also noted diabetes and depression are both linked to unhealthy behaviors such as smoking, poor diet and a sedentary lifestyle, and depression could trigger changes in the nervous system that could lead to heart problems.

"Considering the size of the population that could be affected by these two prevalent disorders, further consideration is required to design strategies aimed to provide adequate psychological management and support among those with long-standing chronic conditions, such as diabetes," Pan concluded.

According to the study, depression affects close to 15 million U.S. adults each year and more than 23.5 million U.S. adults have diabetes. Symptoms of depression affect between one-fifth and one-fourth of patients with diabetes, nearly twice as many as individuals without diabetes. And diabetes is also deadly. The illness and its complications are leading causes of death around the world.

soundoff (57 Responses)

    Maybe it has to do with the fact that doctors do not understand truly what causes diabetes. Maybe it has to do with the fact that many people have diabetes and they live healthy lifestyles already and NOTHING is working. I know a few like that. Not all diabetics are fat pigs who smoke. Get a CLUE.
    Also, why is it that the diabetes medicines eventually fail and most type 2 diabetics still need Insulin?? They 'CLAIM' your pancreas starts acting up but is it really so? Isnt it curious that diabetes pills cost somewhere around 25 bucks and insulin is in the hundreds each month?? WHO STANDS TO MAKE MORE MONEY BY GETTING YOU HOOKED ON INSULIN???

    January 3, 2011 at 17:18 | Report abuse | Reply
    • Michael Superczynski, Columbus, OH

      Tin-foil hat a little tight today?

      January 3, 2011 at 17:43 | Report abuse |
    • Dana

      Actually Michael o' deluded troll, he/she is correct. You need to start thinking for yourself for a change and quit being so naive.

      January 3, 2011 at 18:06 | Report abuse |
    • M

      shut up michael you condescending toolbag.

      January 3, 2011 at 18:10 | Report abuse |
    • mane

      There is scientific evidence about the pancreas and insulin resistance. What proof do you have about your "thesis". If you all don't have any, Mike is right and you all need to adjust your tin hats.

      January 3, 2011 at 19:02 | Report abuse |
    • Steve P

      Very simple...insulin resistance, as is the pathophysiology of type II diabetes, requires increased dosages of insulin. Sulfonylureas increase our endogenous insulin production. The pancreas works harder, cranks out more insulin, the cell receptors become further desensitized/resistant, the pancreas works harder...it's a vicious cycle. Ultimately, yes, the pancreas will burn out and the individual will become exogenous insulin dependent in most cases of long-standing type II diabetes.

      Why don't you start with insulin. Again, simple. First, no patient wants to start with insulin, it's just a matter of fact. Second, if you start with insulin, you are speeding up the resistance process at the cellular level, meaning you will need greater and greater exogenous insulin earlier and earlier and will ultimately be very difficult to control at an earlier age than if you start with the oral anti-diabetics. Also, with two classes of orals, you don't run the real risk of hypoglycemia and the associated dangers. But, most importantly, you don't accelerate the resistance process and inconvenience the patient when there are effective orals, especially with the borderline blood sugar.

      P.S. No, and I mean no, doctors start with insulin in the low-level, newly diagnosed diabetic. But, at the end of the day, almost all are going to end up there because orals are ultimately going to fail.

      January 3, 2011 at 19:27 | Report abuse |
    • Steve P

      I missed part of the question...all orals do one of three things, basically...increase insulin production by your pancreas, decrease gluconeogenesis (our own endogenous sugar production), or increase insulin sensitivity.

      The problem is, all are temporizing measures, all will fail. Insulin resistance will increase. Endogenous insulin production by the pancreas will increase. The pancreas beta cells will burn out while our insulin demand will increase and orals will no longer be able to exert their modest gains. Insulin is the most common endpoint for the diabetic. In an advanced diabetic with serious resistance, you could start with orals but you are wasting your time. One colleague, an endocrinologist, states he starts insulin relatively soon, especially in the established diabetic, to avoid complications of poorly controlled diabetes, despite the accelerated resistance that will ensue.

      Diabetes is going to equate to insulin requirements in most cases except those that control through diet or are only a few points into the "diabetes' blood sugar range.

      January 3, 2011 at 19:35 | Report abuse |
    • IUDoc

      So, diabetes is a sham, eh? How do you feel about diabetes-induced peripheral vascular disease, end stage kidney disease, coronary artery disease, painful neuropathy, gangrenous diabetic ulcers, retinopathy/blindness?

      A sham as well, right? Who saves money with insulin? You, me, the patient, the health care system...by avoiding or delaying the horrible complications of diabetes. Those diabetes pills of which you speak aren't going to get it done alone in many, many cases. Let go of the paranoia, not all medicine is a great scheme to defraud you and steal your wallet.

      January 3, 2011 at 19:52 | Report abuse |
    • rich

      I'm praying you get diabetes.. then you'll know 😀 have a nice day

      January 3, 2011 at 19:57 | Report abuse |
    • Diabetic

      First of all Insulin is an Over The Counter medication like Tylenol and cough syrup. Typical non Rx cost is about $45 per vial. Diabetes is not a sham, it is a killer more than heart disease and cancer. I hope you are blessed with good health because having a chronic illness sucks

      January 3, 2011 at 20:02 | Report abuse |
    • becky

      if you ever have accident or hit people while drunk, START DRINKING AT THE SCENE! That way you have a valid excuse as to why you are drunk. START drinking AFTER the accident!! If you carry a CLOSED bottle of alcohol in your TRUNK at all times, you can easily beat ANY potential conviction!

      January 3, 2011 at 21:58 | Report abuse |
    • furrydoc

      As one of the regional endocrinologists, I need to give a presentation on diabetes at a local Federally Qualilfied Health Center that has a huge population of indigent diabetics. I am not planning to talk to the staff there about sugar but about body parts, which happens to be most of them with relative sparing of the lungs. The medical and dietary treatments are really surrogate interventions to protecting body parts, both those vital for survival like the arteries and those useful to have like the legs. This particular community's citizens does not get optimal intervention and therefore lags behind the general population in things like legs per capita.

      There is some disagreement, as the original poster suggests, as to what the actual efficacy of insulin, oral agents, diet and exercise really turns out to be. There is not shortage of well designed and analyzed studies that show benefit to glucose reduction on kidney and vision protection, very good evidence on statin medicine on heart protection, certain blood pressure agents on kidney protection, preventive podiatry care on foot protection.

      Diabetes is no sham. It is a very difficult medical challenge but a very gratifying one when analyzed and executed in a thoughtful, purposeful way.

      January 4, 2011 at 08:36 | Report abuse |
  2. james

    How do you get diagnosed with depression? "Ma'am, I'd say you're depressed." "Dang, I hate my life and haven't laughed for a month and couldn't figure out why. I thought maybe it was the onset of psoriasis."

    January 3, 2011 at 17:20 | Report abuse | Reply
    • Michael Superczynski, Columbus, OH

      If you are fortunate enough to realize you have a problem, you see a psychologist and discuss it. Over time, a diagnosis is made and you start taking an anti-depression medication like Lexapro.

      Being honest with yourself and your medical professional about your situation can bring about successful treatment. It took 15 years of treatment but I am no longer depressed.

      January 3, 2011 at 17:47 | Report abuse |
    • dawno

      lucky for you you don't know. those who are depressed have no doubt. it is a horrible health concern for many. be thankful you're not one of them.

      January 3, 2011 at 17:59 | Report abuse |
    • Billy

      Not everyone uses medication as treatment for depression Michael. Its not as simple as you are making it out to be. In fact your comments show you know little of anything about the subject.

      January 3, 2011 at 18:14 | Report abuse |
    • Steve P

      Come on, James, that was an incredibly naive post.

      January 3, 2011 at 19:37 | Report abuse |
  3. Common Sense

    I'm so tired of CNN posting 'Terrible Disease' + 'Terrible Disease' = 'Terrible Cardiac Outcome'. Well no kidding. I don't need a $1 million study to tell me that.

    January 3, 2011 at 17:44 | Report abuse | Reply
    • Michael Superczynski, Columbus, OH

      I agree. Some of these articles are like "DUH!".

      January 3, 2011 at 17:48 | Report abuse |
    • Steve P

      Actual quantification of the interactions change the treatment paradigm. They may not be earth-shattering in their association, but the degree of the association is necessary information.

      January 3, 2011 at 19:40 | Report abuse |
  4. 6.1 AIC

    I'm a Type 1 (Juvenile Onset) Diabetic. I'm 50, female and have severe depression. I guess I should be getting my affairs in order.

    January 3, 2011 at 17:58 | Report abuse | Reply
    • Anna

      Yea, that is how this condescending article is coming off. ' Well if you are depressed, just be happy!' OH OK CAPTAIN USELESS!

      January 3, 2011 at 18:09 | Report abuse |
    • Atheria

      No, but you can make changes to help yourself. I am dealing with recent blood sugar problems (numbers are all over the place but low blood sugar has given me the worst problems) and have a diabetic mom who started off like me and didn't take care of her diet and now is pretty bad. Anyway, PLEASE read Dr. Neal Barnard's book on healing diabetes. It will take a drastic change in what you eat (very low fat vegan diet) but he has helped lots of people get of insulin. Now, becuase you are a Type 1, you'll always need insulin, but I bet you anything if you follow his suggestions, you can cut back amounts....AND....his way of eating may help your mood. I am sympathetic to depression as I've battled that on and off my entire life. A quote I heard once that has always stuck to me is: Depression is your soul's way of telling you that you are on the wrong path. - What in your childhood made your heart sing? What things that you loved have you let go of because as an adult "life" takes over....responsibilities, etc. There is a reason you were born. We each need to find what the reason is.

      January 3, 2011 at 18:47 | Report abuse |
    • mto

      @Atheria: what if there was NOTHING AT ALL that made my 'heart sing' in childhood? What if all I wanted as a child was to be a grownup, not be bullied or ostracized by other kids, to have some control over my own life? What if my only pleasure as a child was in eating, reading & sleeping? What if even as an adult I feel like even though I can control more minor things in my life, I can not be loved? And when I love someone I am never good enough for them?

      January 4, 2011 at 04:40 | Report abuse |
  5. Bowling Lover

    Exactly. I am convinced that these Universities are somehow required to sink this grant money into these wasteful and useless studies. They NEVER bother to test how to improve any situations or how to study and prove the validity of natural remedies that have worked for thousands of years. No. Instead lets spend thousands of dollars on why water is wet.

    January 3, 2011 at 18:08 | Report abuse | Reply
  6. Elizabeth

    Once again CNN (like most other news organizations) in this article yet again fails to differentiate between type 1, or Juvenile Diabetes, and type 2. And once again, readers who don't know the difference are led by this irresponsible medi-journalism to believe that ALL diabetics are lazy, fat, dumb, and doomed to a life of closet candy-eating and rising cholesterol. Now THAT'S depressing!!

    January 3, 2011 at 18:40 | Report abuse | Reply
    • Lots of critics but not many detail-oriented readers

      Paragraph three does note a reference to type 2 diabetes: "Reports of type 2 diabetes were noted in questionnaire, filled out by participants."

      January 3, 2011 at 19:10 | Report abuse |
  7. mane

    Dr. Gupta is a brain surgeon and professor of medicine. What are you? Whats your point about his family? For the record, he is not mediocre.

    January 3, 2011 at 19:06 | Report abuse | Reply
  8. Claes

    Wow, what groundbreaking results! Who would have guessed? Honestly, I'm a scientist myself, so I know the stress of just having to publish something... anything... so since you can't publish something that's wrong, the other option is to publish something trivial – an option that represents about 95% of scientific output.

    January 3, 2011 at 19:17 | Report abuse | Reply
    • notmyrealname

      What is "trivial" about this study?

      January 3, 2011 at 19:48 | Report abuse |
  9. Steve P

    There is no such thing as a mediocre neurosurgeon. It's mathematically impossible.

    January 3, 2011 at 19:42 | Report abuse | Reply
  10. notmyrealname

    It amazes me that so many ignoramuses think any research is a "waste of taxpayer money" if it doesn't have some momentous impact on the universe. The amount of your taxes that are used for any of this is miniscule. The research may be useful in future medical experimentation that may at some point HAVE an impact on something important to your little life. In the interim, get a life and shut up about things you neither comprehend nor value. No one cares about your uninformed opinion.

    January 3, 2011 at 19:51 | Report abuse | Reply
  11. becky

    if you ever have accident .. hit people while drunk, START DRINKING AT THE SCENE! That way you have a valid excuse as to why you are drunk. START drinking AFTER the accident!! If you carry a CLOSED bottle of alcohol in your TRUNK at all times, you can easily beat ANY potential conviction!

    January 3, 2011 at 21:59 | Report abuse | Reply
    • Jennifer C.

      Becky/beck, we got it the first time.

      I can see why these people are depressed. All the mean-spirited judgmental people who endlessly dog them is enough to depress anyone. Of course, I guess they just have personality disorders, so it's not their fault they are jerks.

      January 4, 2011 at 05:27 | Report abuse |
  12. beck

    if you ever have accident or hit people while drunk, START DRINKING AT THE SCENE! That way you have a valid excuse as to why you are drunk. START drinking AFTER the accident!! If you carry a CLOSED bottle of alcohol in your TRUNK at all times, you can beat ANY potential conviction!

    January 3, 2011 at 22:01 | Report abuse | Reply
  13. Laurence Girard

    Interesting article! It makes you think about how much the mind body connection truly does exist. The sad thing about depression and type 2 diabetes is that they're both treatable. I have a friend that deals with depression and he refuses to go to the psychiatrist because he doesn't want to admit that he's weak. Most people don't view depression as a real disease which is sad because they'll never seek treatment... and don't get me started by type 2 diabetes. Type 2 diabetes is simply brought on by poor eating habits and lack of exercise. It's really sad because the fast food and snack food industries are the cause of the problem. We need to start dealing with the nutrition problems in this country. High-fructose corn syrup has increased the risk of obesity and diabetes and scientists aren't sure how safe it really is. Princeton University researchers even did a study on mice with high fructose corn syrup. I wrote about it on my blog in an article, here it is -> http://applebananacoconut.com/why-is-high-fructose-corn-syrup-bad-for-you

    January 3, 2011 at 22:28 | Report abuse | Reply
  14. Dianne

    for me, depression = PTSD= compulsive overeater. Managing my reaction to anxiety would be the key to managing my food consumption and therefore my diabetis

    January 3, 2011 at 23:48 | Report abuse | Reply
    • Jennifer C.

      Dianne, I think you nailed it. It requires management, and is not something that can be switched on or off. Some of it may be based on evolution and a natural tendency to eat foods when they are available to store energy for times of famine. And someone who is sensitive or has a lot of trauma in their life may be "distracted" by life events and not easily return to a management regimen. And some people don't have that particular problem but do have personality disorders that lead them to verbally attack those who do, which may then lead to more depression - or self-isolation to avoid the hateful attacks. Not exactly an environment that nurtures healing.

      January 4, 2011 at 05:59 | Report abuse |
  15. Jennifer C.

    This is a very important study–there are new people being diagnosed all the time and diabetes is not an intuitive disease. My great grandmother had type 2 diabetes and was thin and never ate junk food (she didn't even have access to it). Calling people names and shaming them doesn't make most people better. It makes them worse, especially if they are already depressed.

    I've followed Dr. Gupta for years, and I think he's brilliant. Not everyone is a health professional or knowledgeable about diabetes or depression. And I disagree that we can "treat" depression. Psychiatry is still in its infancy, and we have band-aid pharmaceutical therapies plus lifestyle interventions and talk therapies that may or may not work for individuals short- or long-term.

    People need this information, many for the first time. Try having some compassion for people. Of course, lack of compassion is probably a sign of some mental disorder, too.

    January 4, 2011 at 05:44 | Report abuse | Reply
  16. SteveP

    For those posting such things as "duh" or "no surprise", perhaps you would care to elaborate as to what your reasoning as to the pathophysiology behind why in diabetics, a comborbidity of depression would increase the risk of development of coronary artery disease. People think it should be intuitive, but really give it no thought as to why it should be intuitive and accuse Dr. Gupta and CNN of posting something that anyone should guess. I would really love to read any logical scientific insight into a proposed pathophysiology that would make cardiovascular disease more likely in a diabetic with depression than in a diabetic alone. Should be interesting.

    January 4, 2011 at 08:33 | Report abuse | Reply
  17. T2

    as my name suggets, I am a T2 Diabetic. I find the VAST majority of the posts here are based on biased views, no clear medical understanding of diabetes, or pure medical ignorance. Now with that said, no this article is not ground breaking news. The very fact of being diagnosed with diabetes, then being told the very medication we need to take increase our cardio vascular risk by 30% will DEFINITELY cause depression. I know, I went down that road.

    Steve P is CORRECT on why oral meds are not the all cure and why many (but not all) diabetics can require insulin. And Laurence Girard is CORRECT why diabetes is becoming epidemic in the world–our food industry has so dramatically changed since the 50s and that is the source of many T2s. But diabetes also has a proven strong genetic relationship.

    And to squelch the view that all diabetics are fat, lazy and self-induced condition–WRONG!!! I am thin, even now underweight because of diabetes, and a workaholic (always have been). My family has a history of diabetes and NOT one person is obese or lazy.

    January 4, 2011 at 09:01 | Report abuse | Reply
  18. Karen

    It is broadly recognized that the causes of depression are instigated by inflammation in the brain. By eliminating the dietary causes of inflammation one could counteract depression. Too much sugar and starch cause insulin resistance and this is a precursor for diseases of civilization like Type 2 Diabetes. Here you can read all about how to avoid and conquer depression, http://www.cutthecarb.com/how-to-avoid-and-conquer-depression-part-1/

    January 4, 2011 at 09:12 | Report abuse | Reply
  19. AmyLynn

    Sadly what has happened is that the Depression Medications causes diabetes

    Anti depressants are one of the major causes of diabetes type 2. It is a difficult position for the patient because of the need for the depression medications.

    The person on anti depressants must be monitored closely for blood sugar problems often

    The Spirit Happy Diet people have controlled diabetes and depression without medications in many countries SEE HERE http://spirithappy.wordpress.com

    January 4, 2011 at 09:38 | Report abuse | Reply
  20. Rob

    While this is an unfortunate finding, it highlights the need for proper treatment of both conditions. Many people avoid getting treatment for symptoms of mental illness due to cultural or social stigmas against those types of conditions. Some others simply don't want to accept that there might be a problem. The good news is that many people with depression respond well to treatment, both with and without drugs, and live much happier (and possibly healthier, as this article points out) lives because of it.

    As to the diabetes problem, while it is truly an epidemic of massive proportions, the fact is that we have the nutritional tools to almost completely prevent the development of type II diabetes and to help control the disease in those who already have it. Unfortunately, many diabetics refuse to acknowledge the problem and continue with the habits that led them to their problem in the first place. For many people, education and lifestyle training can make the difference between living a healthy, enjoyable life and developing a life-threatening chronic disease that requires life-long medication. With those choices available, it's hard to fathom why one wouldn't choose to make positive changes in their life. I encourage all people, an especially those at risk of developing type II diabetes, to read as much as they can on proper nutrition and reasonable exercise programs and then start to apply those principles to their own lives. Slowly but surely you can make a difference and you will see and feel the changes. Invest the time to learn and make the choice to be disciplined. In many cases, your life depends on it!

    Rational, effective nutrition for fat loss and long-term health: http://www.NutritionPerfected.com/np-blog.html

    January 4, 2011 at 10:42 | Report abuse | Reply
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