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Diabetes and endocrinology
Research
The association between insulin therapy and depression in patients with type 2 diabetes mellitus: a meta-analysis
  1. Xiaosu Bai1,
  2. Zhiming Liu1,
  3. Zhisen Li1,
  4. Dewen Yan2
  1. 1 Department of Endocrinology, People’s Hospital of Longhua, Shenzhen, China
  2. 2 Department of Endocrinology, The Second People’s Hospital of Shenzhen, Shenzhen, China
  1. Correspondence to Dr Xiaosu Bai; bxsllb{at}163.com

Abstract

Objectives Several patients with type 2 diabetes mellitus (T2DM) have depressive disorders. Whether insulin treatment was associated with increased risk of depression remains controversial. We performed a meta-analysis to evaluate the association of insulin therapy and depression.

Design A meta-analysis.

Methods We conducted a systematic search of PubMed, PsycINFO, Embase and the Cochrane Library from their inception to April 2016. Epidemiological studies comparing the prevalence of depression between insulin users and non-insulin users were included. A random-effects model was used for meta-analysis. The adjusted and crude data were analysed.

Results Twenty-eight studies were included. Of these, 12 studies presented with adjusted ORs. Insulin therapy was significantly associated with increased risk of depression (OR=1.41, 95% CI 1.13 to 1.76, p=0.003). Twenty-four studies provided crude data. Insulin therapy was also associated with an odds for developing depression (OR=1.59, 95% CI 1.41 to 1.80, p<0.001). When comparing insulin therapy with oral antidiabetic drugs, significant association was observed for adjusted (OR=1.42, 95% CI 1.08 to 1.86, p=0.008) and crude (OR=1.61, 95% CI 1.35 to 1.93, p<0.001) data.

Conclusions Our meta-analysis confirmed that patients on insulin therapy were significantly associated with the risk of depressive symptoms.

  • depression
  • insulin
  • type 2 diabetes mellitus
  • meta-analysis
  • risk factor

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2017-020062

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    Footnotes

    • Contributors XB contributed to study concepts, manuscript preparation, literature research and drafting the manuscript. ZLi, ZLiu and DY carried out literature research and data analysis, and revised the manuscript for important content. All authors read and approved the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.