title: Antidepressant medication use and glycaemic control in co-morbid type 2 diabetes and depression.
abstract: OBJECTIVE
  Depression is prevalent in diabetes and is associated with increased risks of hyperglycaemia, morbidity and mortality. The effect of antidepressant medication (ADM) on glycaemic control is uncertain owing to a paucity of relevant data. We sought to determine whether the use of ADM is associated with glycaemic control in depressed patients with type 2 diabetes.
  
  
  METHODS
  A retrospective cohort study (n = 1399) was conducted using electronic medical record registry data of ambulatory primary care visits from 2008 to 2013. Depression and type 2 diabetes were identified from ICD-9-CM codes; ADM use was determined from prescription orders; and glycaemic control was determined from measures of glycated haemoglobin (A1c). Good glycaemic control was defined as A1c < 7.0% (53 mmol/mol). Generalized estimating equations were used to determine the effect of depression and ADM use on glycaemic control.
  
  
  RESULTS
  Good glycaemic control was achieved by 50.9% of depressed subjects receiving ADM versus 34.6% of depressed subjects without ADM. After adjusting for covariates, depressed patients receiving ADM were twice as likely as those not receiving ADM to achieve good glycaemic control (odds ratio = 1.95; 95% confidence interval: 1.02-3.71).
  
  
  CONCLUSIONS
  In this retrospective cohort study of a large sample of primary care patients with type 2 diabetes, ADM use was associated with improved glycaemic control.
authors.affiliation: Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO, brielerj@slu.edu.
authors.forename: Jay A
authors.initials: JA
authors.lastname: Brieler
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, St. Louis, MO and The Bell Street Clinic, VA St. Louis Health Care System - John Cochran Division, St. Louis, MO, USA.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Lustman
authors.affiliation: Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO.
authors.forename: Jeffrey F
authors.initials: JF
authors.lastname: Scherrer
authors.affiliation: Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO.
authors.forename: Joanne
authors.initials: J
authors.lastname: Salas
authors.affiliation: Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO.
authors.forename: F David
authors.initials: FD
authors.lastname: Schneider
mesh_terms: D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D015897:Comorbidity; D003866:Depressive Disorder / Q000188:drug therapy* / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000453:epidemiology / Q000378:metabolism*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D065840:Protective Factors; D012042:Registries; D012189:Retrospective Studies
chemical_list: D000928:Antidepressive Agents; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human
keywords: Antidepressive agents; anxiety; depression; diabetes mellitus type 2; medical records; primary health care.