A new study finds a link between the severity of depression and the likelihood of diabetes complications in older patients.
The research, conducted at the Diabetes Centre at Tokyo Women’s Medical University School of Medicine, found that older people with diabetes living with complications such as retinopathy and neuropathy were significantly more likely to report moderate or severe depression.
The study involved 4,283 patients, all of whom were at least 65 years old. The majority of the participants had type 1 diabetes. Each participant completed a questionnaire relating to diabetes complications, then filled in the Patient Health Questionnaire-9 to measure symptoms of depression. Severity of depression was ranked by the following categories: 0 to 4 points (no depression), 5 to 9 points (mild depression) and 10 points or more (which indicated moderate or severe depression).
69.5 per cent of participants reported no depression; 19.7 per cent of participants had mild depression; and 10.9 per cent reported moderate or severe depression. Those with moderate or severe depression had higher odds ratios for retinopathy, neuropathy and end-stage renal disease.
“The more severe depressive symptoms there were, the greater the tendency we observed for diabetic microangiopathies and macroangiopathies,” said Kaya Ishizawa, of the Diabetes Centre at Tokyo Women’s Medical University School of Medicine. “Odds ratios for diabetic complications, except for gangrene, significantly increased with [Patient Health Questionnaire-9] scores.”
The study provides further evidence of the importance of proper mental health support in the treatment of diabetes. Studies suggest that people with diabetes are between two and three times more likely to experience depression than people without diabetes, and untreated depression has been consistently linked to higher blood glucose levels and therefore a greater risk of diabetic complications.
The findings are published in the Journal of Diabetes Complications.

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