Bidirectional Association Between Depression and Type 2 Diabetes Mellitus in Women
An PanMichel LucasQi SunRob M. van DamOscar H. FrancoJoAnn E. MansonWalter C. WillettAlberto AscherioFrank B. Hu
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Although it has been hypothesized that the diabetes-depression relation is bidirectional, few studies have addressed this hypothesis in a prospective setting.A total of 65 381 women aged 50 to 75 years in 1996 were observed until 2006. Clinical depression was defined as having diagnosed depression or using antidepressants, and depressed mood was defined as having clinical depression or severe depressive symptoms, ie, a 5-item Mental Health Index (MHI-5) score of 52 or less. Self-reported type 2 diabetes mellitus was confirmed by means of a supplementary questionnaire validated by medical record review.During 10 years of follow-up (531 097 person-years), 2844 incident cases of type 2 diabetes mellitus were documented. Compared with referents (MHI-5 score of 86-100) who had the best depressive symptom scores, participants with increased severity of symptoms (MHI-5 scores of 76-85 or 53-75, or depressed mood) showed a monotonic elevated risk of developing type 2 diabetes (P for trend = .002 in the multivariable-adjusted model). The relative risk for individuals with depressed mood was 1.17 (95% confidence interval [CI], 1.05-1.30) after adjustment for various covariates, and participants using antidepressants were at a particularly higher relative risk (1.25; 95% CI, 1.10-1.41). In a parallel analysis, 7415 cases of incident clinical depression were documented (474 722 person-years). Compared with nondiabetic subjects, those with diabetes had a relative risk (95% CI) of developing clinical depression after controlling for all covariates of 1.29 (1.18-1.40), and it was 1.25 (1.09-1.42), 1.24 (1.09-1.41), and 1.53 (1.26-1.85) in diabetic subjects without medications, with oral hypoglycemic agents, and with insulin therapy, respectively. These associations remained significant after adjustment for diabetes-related comorbidities.Our results provide compelling evidence that the diabetes-depression association is bidirectional.Keywords:
Depression
The results of treatment of 103 patients with tuberculosis and non-specific diseases of the lungs with concomitant diabetes mellitus were analysed. The main principles of preoperative preparation and postoperative management of the patients are presented. The incidence of operative complications was 10.7%, postoperative--17.5%, mortality--2.9%. The clinical effect was achieved in 97.1% of patients. Reactivation of tuberculosis after operation was noted in 7.8% of patients.
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Objective: The aim of this study was to explore the effects and safety of low-dose hydrocortisone in patients with septic shock. Methods: The PubMed, EMBASE, and Cochrane Central Register of Controlled Trials were searched from database inception until 1 August 2018. Two reviewers performed literature selection, data extraction, and quality evaluation independently. Results: Twelve randomized controlled trials were included in this meta-analysis. The combined results showed that low-dose hydrocortisone use had no survival benefit in patients with septic shock (relative risk = 1.09; 95% confidence interval = 0.88–1.05; P = 0.37). But low-dose hydrocortisone use was useful for shock reverse (relative risk = 1.09; 95% confidence interval = 1.00–1.19; P = 0.04) and in shortening the time of vasopressor support (weighted mean difference = −1.79, 95% confidence interval = −2.05 to −1.52; P < 0.00001). In addition, use of low-dose hydrocortisone was associated with a higher risk of hyperglycemia (relative risk = 1.21; 95% confidence interval = 1.04–1.40; P = 0.01) and hypernatremia (relative risk = 6.34; 95% confidence interval = 1.19–33.81; P = 0.03). There was no significant improvement of intensive care unit mortality (relative risk = 1.11; 95% confidence interval = 0.93–1.33; P = 0.23) or hospital mortality (relative risk = 1.08; 95% confidence interval = 0.94–1.24; P = 0.29), length of intensive care unit (weighted mean difference = −1.84; 95% confidence interval = −5.80 to 2.11; P = 0.36) or length of hospital (weighted mean difference = 0.11; 95% confidence interval = −2.06 to 2.29; P = 0.98), and time of mechanical support (weighted mean difference = −0.69; 95% confidence interval = −1.76 to −0.38; P = 0.20) with the use of low-dose hydrocortisone. There was no significant difference in secondary infection (relative risk = 1.04; 95% confidence interval = 0.91–1.18; P = 0.57), recurrence of shock (relative risk = 1.47; 95% confidence interval = 0.64–3.39; P = 0.36), and gastrointestinal bleeding (relative risk = 1.41; 95% confidence interval = 0.89–2.22; P = 0.14) with the use of low-dose hydrocortisone. Conclusion: Although there was no effect of low-dose hydrocortisone on survival of patients with septic shock, it is associated with a higher rate of shock reversal and shortening duration of vasopressor support; thus, low-dose hydrocortisone may be an alternative drug in septic shock patients who are refractory to fluid resuscitation and vasopressors.
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Objective:To investigate the prevalence and clinical features of depression in patients with diabetes mellitus.Methods:Eighty five patients with diabetes in our department were evaluated with Hamilton rating scale for depression from Apr 2009 to Apr 2010.Results:The prevalence of depression in patients with diabetes was 18.82% in which female prevalence of depression was 28.21% and male was 10.87%.Female patients was a higher prevalence than that of male patients in which there was statistical significance(P0.05).Conclusion:Prevalence of depression in patients with diabetes mellitus should be paid attention and give them mental nursing in time.
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Abstract Background Diabetes is related with both AF occurence and increased thromboembolic risk. There is scarce data about the outcomes of AF catheter ablation in patients with diabetes. Purpose We aimed to evaluate outcomes of AF catheter ablation in patients with diabetes. Methods All patients underwent AF cryoablation between January 2013 and January 2018 were included . Results A total of 493 patients were enrolled. Mean age was 59.6 ± 11.8 years and 253 (51.3 %) patients were female. Median follow up time was 28 (6-59) months. Recurrence occured in 61 (12.4%) patients. Diabetes was present in 78 (16%) cases. Mean HbA1c value of the diabetic patients was 6.79 ± 1.02 %. 50 (64.1 %) patients was under treatment with only oral antidiabetics while others were using insulin. Diabetic group was older (p < 0.001) and hypertension prevalance was significantly higher in diabetics(p < 0.001). Complication and recurrence rates were similar between the two groups (Table-1). Subgroup analysis revealed that there was not significant difference by AF recurrence between not only patients treated with OAD alone and treated with insulin but also patients with HbA1c value <7 and HbA1c value ≥7 (p = 0.064). Conclusion Recurrence and complication rates were similar between diabetic and non-diabetic patients. Despite neuropathy is a well known manifestation of diabetes; phrenic nerve damage rate is similar in diabetic patients with non-diabetic counterparts. Table-1 Diabetic group (n = 78) Non-diabetic group (n = 415) p value Age, (years) 64.38 ±10.12 58.91 ±11.84 <0.001* Gender, female (%) 45 (57 %) 207 (49.8 %) 0.267 Follow up, (months) 29.5 (6-59) 28 (6-58) 0.987 Hypertension, n (%) 57 (73%) 191 (46 %) <0.001 StrokeTIA, n(%) 4 (5.1 %) 8 (1.9 %) 0.104 Coronary artery disease, n (%) 39 (50 %) 176 (42.4 %) 0.242 AF type, Paroxysmal, (%) 65.7 % 71% 0.367 LV EF, % 59.81 ± 8.44 61.82 ± 6.89 0.027* LV end diastolic diameter, cm 4.90 ± 0.49 4.82 ± 0.46 0.160 LA diameter, cm 3.88 ± 0.51 3.81± 0.58 0.361 Recurrence 8 (10.2 %) 53 (12.7 %) 0.708 Phrenic nerve damage, n (%) 0 (0 %) 17 (4.1 %) 0.088 Inguinal hematoma, n (%) 7 (8.9%) 44 (10.6 %) 0.647 Pseudoaneurysm, n(%) 1 ( 1.2%) 3 ( 0.7 %) 0.502 Comparison of diabetic and non-diabetic patients
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Background Diabetic dermopathy is the most common cutaneous marker of diabetes mellitus. The relationship of diabetic dermopathy to internal complications of diabetes mellitus, such as nephropathy, retinopathy, and neuropathy, is still unknown. Methods The possible role of diabetic dermopathy as a clinical sign of internal complications in diabetes mellitus was investigated. One hundred and seventy‐three patients with diabetes mellitus, of whom 125 (72%) had insulin‐dependent diabetes mellitus and 48 (28%) had non‐insulin‐dependent diabetes mellitus, were studied. Results Diabetic dermopathy was present in 69 (40%) of patients, statistically more significant in patients 50 years of age and older. The mean diabetic duration was significantly higher in patients with diabetic dermopathy than in those without. The associations of diabetic dermopathy with retinopathy, nephropathy, and neuropathy were each statistically significant, and the increased frequency of diabetic dermopathy correlated with an increased number of these three complications in each patient. Conclusions Some of the factors that affect the development of internal complications in diabetes mellitus may play a role in the development of diabetic dermopathy, and diabetic dermopathy may serve as a clinical sign of an increased likelihood of these internal complications in diabetic patients.
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Risk factors for arteriosclerosis, such as age, duration of diabetes, sex, and plasma lipoprotein levels, were correlated with the presence of arteriosclerosis obliterans (ASO) as determined by noninvasive methods in 485 of 506 subjects studied with diabetes mellitus. The diabetic subjects were separated into two major groups for analysis: insulin-dependent diabetes mellitus (IDDM) and non-insulin-dependent diabetes mellitus (NIDDM). The NIDDM group was subdivided into those treated by diet (NIDDM-D), sulfonylureas (NIDDM-S), and insulin (NIDDM-I). Overall, lipoprotein levels in the diabetics were higher than in an age- and sex-adjusted nondiabetic group. Cholesterol levels were elevated in all females and HDL cholesterol levels were depressed in diet- and sulfonylurea-treated females. VLDL levels were most elevated in diet-treated subjects followed by sulfonylurea-treated subjects; VLDL levels in insulin-treated subjects were not elevated. The prevalence of ASO is related to different factors in each group. In IDDM and NIDDM-I subjects, VLDL triglyceride, LDL cholesterol, and duration of diabetes or age are important risk indicators. By contrast, in NIDDM-S subjects, age alone is the significant risk indicator, and in NIDDM-D subjects, inverse HDL cholesterol correlated with ASO. While males have a higher prevalence of ASO than females, the difference is not statistically significant in any group. Other possible factors, such as hypertension, smoking, and obesity, were not considered in this initial analysis.
Arteriosclerosis obliterans
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Evidence of increased type 2 diabetes (T2D) risk associated with potatoes consumption is equivocal. We aimed to perform a meta-analyses on the association between potatoes consumption and T2D risk in prospective cohort studies. Studies published prior to 31 Aug 2016 were identified in PubMed, EMBASE, and Web of Science. Pooled relative risks (RR) and 95% confidence intervals (95%CI) based upon the highest vs. lowest category of potatoes consumption in each study were calculated in meta-analysis using random-effects models. Dose-response meta-analysis was fitted using generalized least squares regression in order to quantify the association between potatoes consumption and T2D risk. The pooled RR comparing the highest vs. lowest category of potato consumption was 1.077 (95%CI: 1.005, 1.155). Dose-response meta-analysis revealed T2D risk increased 3.5% (RR=1.035, 95% CI: 1.004-1.067) for additional three serving per week serving of potato. The pooled RR comparing the highest vs. lowest category of French fries consumption was 1.362 (95%CI: 1.004, 1.850). Dose-response meta-analysis indicated T2D risk increased 18.7% (RR = 1.187, 95% CI: 1.067-1.321) for additional three serving per week of French fries. This meta-analysis support a significant positive association between high potatoes consumption and risk of T2D, especially the consumption of French fries.
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Objective:To investigate the prevalence rate of depression in diabetic population and the relationship between diabetes mellitus(DM)and depression.Methods:226 patients with diabetes mellitus were interviewed and analyzed by HAMD,EPQ,MCMQ and SSRS.Results:The prevalence rate of depression in diabetes mellitus was 28.32%.Depression was found to be correlated with some factors in diabetic patients,which were sex,age,course,BMI,HbA1c,diabetic complications and psychosocial factors.Conclusion:The prevalence rate of depression in diabetes mellitus is high.There are tight relation between depression and diabetic mellitus.
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Basal and maximal Ca2+ ATPase activity was studied in erythrocytes of 29 healthy controls, 15 patients with insulin-dependent diabetes mellitus (IDDM) and 22 patients with non-insulin-dependent diabetes mellitus (NIDDM). Basal and maximal Ca2+ ATPase activity was significantly decreased in insulin-dependent diabetes mellitus (8.4±0.5 and 22.5±1.1 pmol/106 RBC/min) and non-insulin-dependent diabetes mellitus (7.3±1.0 and 18.6±1.8 pmol/106 RBC/min) compared to healthy controls (9.3±1.0 and 24.6±1.1 pmol/106 RBC/min). Maximal Ca2+ ATPase activity showed a significant correlation to systolic blood pressure in both insulin-dependent diabetes mellitus and non-insulin-dependent diabetes mellitus. There was no significant correlation of maximal Ca2+ ATPase activity to fasting serum glucose concentration and to HbA1 levels. Maximal Ca2+ ATPase activity was significantly correlated to creatinine clearance in non-insulin-dependent diabetes mellitus, but not in insulin-dependent diabetes mellitus. It is concluded that a decreased cellular Ca2+ ATPase activity may predispose to the development of hypertension in diabetes mellitus.
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