Effect of depression on mortality in type 2 diabetes mellitus after 8 years of follow-up. the diadema study.

AIM to assess the effect of depression on all-cause mortality in patients with type 2 diabetes mellitus (T2DM) followed up during 8 years in primary care in Spain. METHODS Depression was diagnosed according to MINI 5.0.0 questionnaire, physician-diagnosis or following antidepressant therapy for at least two months in 3,923 people with T2DM. We analyzed mortality-rates/10,000 person-years. We compared survival according to baseline depression with Kaplan-Meier estimates and the log-rank test. We performed Cox proportional hazard model analyses. RESULTS Baseline depression was diagnosed in 22.1% of participants. Mortality was higher in patients with depression (31.9% vs. 26.9%; p=0.003), who had a significantly poorer survival (median survival=7.4 vs. 7.8 years, respectively; Log Rank=15.83; p 75 years (HR=6.04; 95%CI:4.62-7.91; p<0.001), insulin use (HR=2.37; 95%CI:1.86-3.00; p<0.001), lower limb amputation (HR=1.99; 95%CI:1.28-3.11; p=0.002), heart failure (HR=1.94; 95%CI:1.63-2.30; p<0.001), and male gender (HR=1.90; 95%CI:1.59-2.27). CONCLUSION In a Spanish cohort of older T2DM patients, depression was associated with a higher mortality risk. More efforts are needed to minimize the influence of depression on mortality in people with T2DM and to implement measures that allow its early diagnosis and effective treatment.