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Varying HbA1c linked to depression in older people with type 2 diabetes

Fluctuating long-term HbA1c levels could be linked with symptoms of depression in older people with type 2 diabetes, according to a recent study.
An Israeli research team looked at data spanning nine years from 837 people who all had type 2 diabetes and were aged on average about 73.
Taking into account the participants’ HbA1c levels, they found that for each one per cent of variability, there was a 29 per cent rise in the symptoms of depression.
Speaking to Reuters Health, Dr Ramit Ravona-Springer from Sheba Medical Center, Ramat Ga, and Tel-Aviv University, said: “The results suggest that maintaining stability in glycemic control may be important for prevention of depressive symptoms in elderly diabetic patients.”
However, the researchers say the results of the study only prove there is a link between the two conditions and it is not conclusive that swinging blood sugar levels can cause depression.
“This study is ongoing,” added Ravona-Springer. “We thus expect to have even better understanding of the directional relationships of glycemic control and other diabetes-related characteristics with depression as we start analysing longitudinal data.”
The researchers stressed, though, that keeping good control of blood glucose levels is important to lower the risk of depression in older people.
Dr Dominic Ehrmann from the Research Institute of the Diabetes Academy Mergentheim (FIDAM) in Bad Mergentheim, Germany, has also looked at the association between type 2 diabetes and depression in previous studies.
Ehrmann said: “The study hints at the importance of achieving stable HbA1c values at a certain age/point in a patients’ diabetes history in contrast to trying to reduce HbA1c. But (and this is a big but) this must be weighed against other clinical and medical objectives (e.g., complications, comorbidities, cognitive functioning).
“Depression/depressive symptoms should be an important factor in clinical decision making in elderly patients. That is, the impact of therapy adjustments or changing treatment goals on depressive symptoms should be considered in clinical practice.”
The findings were published in Diabetes Care.

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