Weight Loss Impact on Change in Depression in Type 2 Diabetes Mellitus: Study to Help Improve Early Evaluation and Management of Risk Factors Leading to Diabetes (SHIELD)

Susan  Grandy; Andrew J.  Green; Kathleen M.  Fox

doi:10.4236/jdm.2014.43031

Susan Grandy, Andrew J. Green, Kathleen M. Fox

Abstract: Objectives: This study evaluated the association between weight loss and change in depression among patients with type 2 diabetes mellitus (T2DM). Methods: Weight change from 2008 to 2009 among respondents (with and without T2DM) in the Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD) was calculated. Change in depression was calculated as change from 2008 to 2009 in Patient Health Questionnaire-9 (PHQ-9) scores. Respondents with weight loss (>1%, >3%, >5%) were compared with respondents with weight gain (≥1%). Multivariate regression adjusted for baseline characteristics. Results: Among those with T2DM, more respondents with weight loss (n = 779) improved their depression scores, compared with respondents with weight gain (n = 731): 32.9%, 36.9%, 39.8% for >1%, >3%, and >5% weight loss, respectively, vs. 28.7% for weight gain (p<0.05). More respondents with weight loss improved the severity level of depression compared with respondents with weight gain (p < 0.05). After adjustment, T2DM respondents with weight loss had significantly greater improvement in depression scores (p < 0.05) and had 2 - 3 times higher odds of improving depression severity than T2DM respondents with weight gain (OR: 2.22 for >1%, 2.96 for >3%, and 3.31 for >5% weight loss, p < 0.01). Similar improvement in depression scores and severity of depression related to weight loss was observed among all SHIELD respondents (with and without T2DM). Conclusions: Our findings demonstrate an association between weight loss and improvement in depression over a 1-year period in adults with T2DM, and suggest the need for further investigation with respect to causality.

Keywords: Depression, Type 2 Diabetes Mellitus, Weight Loss

Cite this paper: Grandy, S. , Green, A. and Fox, K. (2014) Weight Loss Impact on Change in Depression in Type 2 Diabetes Mellitus: Study to Help Improve Early Evaluation and Management of Risk Factors Leading to Diabetes (SHIELD). Journal of Diabetes Mellitus, 4, 216-224. doi: 10.4236/jdm.2014.43031.

References

[1] American Diabetes Association (2010) Standards of Medical Care in Diabetes-2010. Diabetes Care, 33, S11-S61. http://dx.doi.org/10.2337/dc10-S011

[2] Chaudhuri, A., Rosenstock, J., DiGenio, A., Meneghini, L., Hollander, P., McGill, J.B., et al. (2012) Comparing the Effects of Insulin Glargine and Thiazolidinediones on Plasma Lipids in Type 2 Diabetes: A Patient-Level Pooled Analysis. Diabetes/Metabolism Research and Reviews, 28, 258-267.
http://dx.doi.org/10.1002/dmrr.1305

[3] Morgan, C.L., Jenkins-Jones, S., Evans, M., Barnett, A.H., Poole, C.D. and Currie, C.J. (2012) Weight Change in People with Type 2 Diabetes: Secular Trends and the Impact of Alternative Antihyperglycaemic Drugs. Diabetes, Obesity and Metabolism, 14, 424-432.
http://dx.doi.org/10.1111/j.1463-1326.2011.01552.x

[4] Pinelli, N.R. and Hurren, K.M. (2011) Efficacy and Safety of Long-Acting Glucagon-Like Peptide-1 Receptor Agonists Compared with Exenatide Twice Daily and Sitagliptin in Type 2 Diabetes Mellitus: A Systematic Review and MetaAnalysis. The Annals of Pharmacotherapy, 45, 850-860.
http://dx.doi.org/10.1345/aph.1Q024

[5] Bolinder, J., Lunggren, O., Kulberg, J., Johansson, L., Wilding, J., Langkilde, A.M., et al. (2012) Effects of Dapagliflozin on Body Weight, Total Fat Mass, and Regional Adipose Tissue Distribution in Patients with Type 2 Diabetes Mellitus with Inadequate Glycemic Control on Metformin. The Journal of Clinical Endocrinology Metabolism, 97, 1020-1031. http://dx.doi.org/10.1210/jc.2011-2260

[6] Feldstein, A.C., Nichols, G.A., Smith, D.H., Stevens, V.J., Bachman, K., Rosales, A.G. and Perrin, N. (2008) Weight Change in Diabetes and Glycemic and Blood Pressure Control. Diabetes Care, 31, 1960-1965. http://dx.doi.org/10.2337/dc08-0426

[7] Anderson, J.W., Kendall, C.W.C. and Jenkins, D.J.A. (2003) Importance of Weight Management in Type 2 Diabetes: Review with Meta-Analysis of Clinical Studies. The Journal of the American College of Nutrition, 22, 331-339. http://dx.doi.org/10.1080/07315724.2003.10719316

[8] Grandy, S., Fox, K.M., Hardy, E., for the SHIELD Study Group (2012) Association of Weight Loss and Medication Adherence among Adults with Type 2 Diabetes Mellitus: SHIELD (Study to Help Improve Early Evaluation and Management of Risk Factors Leading to Diabetes). Current Therapeutic Research, 75, 77-82. http://dx.doi.org/10.1016/j.curtheres.2013.06.004

[9] Diabetes Prevention Program Research Group (2012) Long-Term Safety, Tolerability, and Weight Loss Associated with Metformin in the Diabetes Prevention Program Outcomes Study. Diabetes Care, 35, 731-737. http://dx.doi.org/10.2337/dc11-1299

[10] Grandy, S., Fox, K.M. and Bazata, D.D. (2012) Association of Self-Reported Weight Change and Quality of Life, and Exercise and Weight Management Behaviors among Adults with Type 2 Diabetes Mellitus: The SHIELD Study. Cardiology Research and Practice, 2012, Article ID: 892564.
http://dx.doi.org/10.1155/2012/892564

[11] Bays, H.E., Chapman, R.H., Grandy, S., for the SHIELD Investigators’ Group. (2007) The Relationship of Body Mass Index to Diabetes Mellitus, Hypertension and Dyslipidaemia: Comparison of Data from Two National Surveys. International Journal of Clinical Practice, 61, 737-747.
http://dx.doi.org/10.1111/j.1742-1241.2007.01336.x

[12] Bays, H.E., Bazata, D.D., Clark, N.G., Gavin 3rd, J.R., Green, A.J., Lewis, S.J., et al. (2007) Prevalence of Self-Reported Diagnosis of Diabetes Mellitus and Associated Risk Factors in a National Survey in the US Population: SHIELD (Study to Help Improve Early Evaluation and Management of Risk Factors Leading to Diabetes). BMC Public Health, 7, 277. http://dx.doi.org/10.1186/1471-2458-7-277

[13] US Census Bureau (2003) Annual Supplement to the Current Population Survey: Census Bureau Resident Population Estimates of the United States. US Census Bureau, Washington DC.

[14] Kroenke, K., Spitzer, R.L. and Williams, J.B.W. (2001) The PHQ-9: Validity of a Brief Depression Severity Measure. Journal of General Internal Medicine, 16, 606-613.
http://dx.doi.org/10.1046/j.1525-1497.2001.016009606.x

[15] Blissmer, B., Riebe, D., Dye, G., Ruggiero, L., Greene, G. and Caldwell, M. (2006) Health-Related Quality of Life Following a Clinical Weight Loss Intervention among Overweight and Obese Adults: Intervention and 24 Month Follow-Up Effects. Health and Quality of Life Outcomes, 4, 43.
http://dx.doi.org/10.1186/1477-7525-4-43

[16] Samsa, G.P., Kolotkin, R.L., Williams, G.R., Nguyen, M.H. and Mendel, C.M. (2001) Effect of Moderate Weight Loss on Health-Related Quality of Life: An Analysis of Combined Data from 4 Randomized Trials of Sibutramine vs Placebo. American Journal of Managed Care, 7, 875-883.