title: Depressive symptoms, antidepressant medication use, and new onset of diabetes in participants of the diabetes prevention program and the diabetes prevention program outcomes study.
abstract: OBJECTIVE
  To assess in the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study whether diagnosis of diabetes predicted elevated depressive symptoms (DS) or use of antidepressant medicine (ADM) following diagnosis; whether diabetes status or duration had significant effect on DS or ADM use; and to determine the associations between A1C, fasting plasma glucose (FPG), normalization of FPG, and DS or ADM use after diagnosis.
  
  
  METHODS
  Diabetes Prevention Program participants in three treatment arms (intensive life style, metformin, placebo) were assessed for diabetes, glucose control, ADM use, and DS, measured using the Beck Depression Inventory (BDI). Among 3234 participants, 1285 developed diabetes. Depression levels were measured before and after diabetes diagnosis.
  
  
  RESULTS
  Neither DS nor use of ADM increased after diagnosis; higher FPG was associated with greater ADM use in the intensive life style arm; a 10-mg/dl rise in FPG is associated with greater odds of ADM use. Higher FPG and A1C were associated with higher BDI scores in all three arms; A 10-mg/dl rise in FPG had a 0.07 increase in BDI. A 1% higher A1c was associated with a 0.21-point increase in BDI. Normalization of FPG was associated with lower BDI. When FPG had normalized, there was a decrease of 0.30 points in the BDI score compared when FPG had not normalized.
  
  
  CONCLUSIONS
  Contrary to clinical attributions, diabetes diagnosis did not show an immediate impact on BDI scores or ADM use. Higher glucose levels after diagnosis were associated with a small but significantly higher BDI score and more ADM use.
  
  
  BACKGROUND
  DPPOS: NCT00038727; DPP: NCT00004992.
authors.affiliation: From the Department of Medicine (Marrero, de Groot), Indiana University School of Medicine, Indianapolis, Indiana; The Biostatistics Center (Ma), George Washington University, Rockville, Maryland; Harvard Medical School (Horton), Boston, Massachusetts; Institute for Health Research (Price), Kaiser Permanente, Denver, Colorado; Department of Family Medicine (Barrett-Connor), University of California, San Diego, California; Department of Medicine (Carnethon), Northwestern University Feinberg School of Medicine, Chicago, Illinois; National Institute of Diabetes and Digestive and Kidney Diseases (Knowler), Phoenix, Arizona.
authors.forename: David G
authors.initials: DG
authors.lastname: Marrero
authors.forename: Yong
authors.initials: Y
authors.lastname: Ma
authors.forename: Mary
authors.initials: M
authors.lastname: de Groot
authors.forename: Edward S
authors.initials: ES
authors.lastname: Horton
authors.forename: David W
authors.initials: DW
authors.lastname: Price
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Barrett-Connor
authors.forename: Mercedes R
authors.initials: MR
authors.lastname: Carnethon
authors.forename: William C
authors.initials: WC
authors.lastname: Knowler
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003863:Depression / Q000150:complications / Q000188:drug therapy*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008687:Metformin / Q000627:therapeutic use*; D008875:Middle Aged; D011236:Prediabetic State / Q000150:complications / Q000628:therapy*; D040242:Risk Reduction Behavior; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D007004:Hypoglycemic Agents; D008687:Metformin