Foundation Article

Lustman PJ, Anderson RJ, Freedland KE, de Groot MK, Carney RM, Clouse RE: Depression and poor glycemic control: a meta-analytic review of the literature. Diabetes Care 23:934–942, 2000

Summary and Commentary

Evidence that depression is associated with hyperglycemia and diabetes spans case reports and series, cross-sectional studies, and randomized clinical trials. Several reports describe peripheral insulin resistance and hyperinsulinemia in individuals with depression.^16–18 Chiba et al.¹⁹ reported that depressed nondiabetic patients had decreased insulin sensitivity compared to nondepressed nondiabetic controls. Okamura et al.²⁰ studied 20 nondiabetic depressed patients with oral and frequently sampled intravenous glucose tolerance tests before and after treatment with tricyclic antidepressants. They observed that non-diabetic depressed patients had decreased insulin sensitivity compared to nondepressed nondiabetic control subjects. After treatment, the patients with depression showed significant increases in insulin sensitivity. Lustman et al. performed this metaanalytic review of the literature in order to help clarify whether depression is associated with poor glycemic control.

Studies published within the 25-year period before the meta-analysis were screened for inclusion. Included studies were limited to those that used adult participants and collected hemoglobin A_1c (A1C) and depression information at the time of study assessment. Studies were excluded from the meta-analysis if they had fewer than 25 participants, were not available in English, or collected only a history of depression. Using established meta-analytic …