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Depressive Symptoms Associated With Premature Mortality in Type 1 Diabetes

PITTSBURGH, June 16, 2014 – People with type 1 diabetes have a higher risk of premature death as their number of depressive symptoms increases, a University of Pittsburgh Graduate School of Public Health analysis reveals.

The findings were presented in a press conference at the American Diabetes Association’s 74th Scientific Sessions in San Francisco and used data collected through the Pittsburgh Epidemiology of Diabetes Complications Study, a long-term study of health complications in people with type 1 diabetes.

“Through the 25 years that we’ve been running this study, we’ve found that there’s a lot more to diabetes than high blood sugar,” said senior author Trevor Orchard, M.D., professor of epidemiology at Pitt Public Health. “This link between premature mortality and depression adds to our previous findings, which show that depressive symptomatology predicts cardiovascular disease and demonstrates that doctors need to consider more than adjusting insulin doses when treating type 1 diabetes.”

Lead author Cassie Fickley, M.P.H., C.P.H., analyzed data on 458 study participants with type 1 diabetes who were assessed using the Beck Depression Inventory, a 32-point scale that measures depressive symptoms ranging from loss of appetite to suicidal tendencies. People who score 16 or more points are considered likely to be clinically depressed.

“For every one-point increase on the scale, participants showed a 4 percent increase in risk for mortality, even after controlling for other relevant factors, such as age, gender, smoking, cholesterol levels and high blood pressure,” said Ms. Fickley, a doctoral student in Pitt Public Health’s Department of Epidemiology. “That’s a significant increase and is something we’ll need to explore more to determine if treating depression would translate into lower mortality in people with type 1 diabetes.”

Type 1 diabetes is usually diagnosed in children and young adults and happens when the body does not produce insulin, a hormone that is needed to convert sugar into energy. The disease can lead to nerve, kidney, eye and heart complications but can be controlled with insulin therapy and other treatments.

The Pittsburgh Epidemiology of Diabetes Complications Study is an investigation to document long-term complications of type 1 diabetes among patients at Children’s Hospital of Pittsburgh between 1950 and 1980. Funded by the National Institutes of Health, the study recently was renewed for another five years.

“It is thanks to the volunteers who participate in this study that we are able to make discoveries like this that will contribute to better therapies and life expectancy for children diagnosed with type 1 diabetes today and in the future,” said Dr. Orchard. 

Additional authors on this study are Tina Costacou, Ph.D., of Pitt; and Cathy E. Lloyd, Ph.D., of the Open University in the United Kingdom.

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