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Fam Pract. 2016 Feb;33(1):30-6. doi: 10.1093/fampra/cmv100. Epub 2016 Jan 7.

Antidepressant medication use and glycaemic control in co-morbid type 2 diabetes and depression.

Author information

1
Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO, brielerj@slu.edu.
2
Department of Psychiatry, Washington University School of Medicine, St. Louis, MO and The Bell Street Clinic, VA St. Louis Health Care System - John Cochran Division, St. Louis, MO, USA.
3
Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO.

Abstract

OBJECTIVE:

Depression is prevalent in diabetes and is associated with increased risks of hyperglycaemia, morbidity and mortality. The effect of antidepressant medication (ADM) on glycaemic control is uncertain owing to a paucity of relevant data. We sought to determine whether the use of ADM is associated with glycaemic control in depressed patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS:

A retrospective cohort study (n = 1399) was conducted using electronic medical record registry data of ambulatory primary care visits from 2008 to 2013. Depression and type 2 diabetes were identified from ICD-9-CM codes; ADM use was determined from prescription orders; and glycaemic control was determined from measures of glycated haemoglobin (A1c). Good glycaemic control was defined as A1c < 7.0% (53 mmol/mol). Generalized estimating equations were used to determine the effect of depression and ADM use on glycaemic control.

RESULTS:

Good glycaemic control was achieved by 50.9% of depressed subjects receiving ADM versus 34.6% of depressed subjects without ADM. After adjusting for covariates, depressed patients receiving ADM were twice as likely as those not receiving ADM to achieve good glycaemic control (odds ratio = 1.95; 95% confidence interval: 1.02-3.71).

CONCLUSIONS:

In this retrospective cohort study of a large sample of primary care patients with type 2 diabetes, ADM use was associated with improved glycaemic control.

KEYWORDS:

Antidepressive agents; anxiety; depression; diabetes mellitus type 2; medical records; primary health care.

PMID:
26743722
DOI:
10.1093/fampra/cmv100
[Indexed for MEDLINE]

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