Depression Increases Risk of Severe Hypoglycemic Events

Depression appears to increase the number of severe hypoglycemic episodes in diabetes patients, according to the results of a study published in the May/June 2013 issue of Annals of Family Medicine.

The study included a sample of 4117 diabetes patients from Washington State who were initially sampled between 2000 and 2002 and followed up with 5 years later. During the 5-year follow-up period, researchers found that 10.7% of the depressed patients had at least 1 severe hypoglycemic episode that required either an emergency department visit or hospitalization compared with 6.4% of the non-depressed patients.

After adjusting for sociodemographic factors, diabetes severity, non-diabetes-related medical comorbidity, prior hypoglycemic episodes, and health risk behaviors, the depressed patients had a significantly higher risk of a severe hypoglycemic episode (hazard ratio of 1.42) and a greater number of hypoglycemic episodes (odds ratio of 1.34).

The researchers note that possible causes for the association between depression and increased risk of hypoglycemic episodes include poor adherence to diet, smoking cessation, and physical activity recommendations among those who are depressed. They note as well that the study strengths include availability of detailed information regarding participants’ potential confounders; weaknesses included the fact that only severe hypoglycemic events were detected and that depression was measured at a single point.