Diabetes, depression combo boosts heart risk

A heart patient with depression and Type 2 diabetes has a 20 to 30 per cent higher risk of dying compared to a person with a heart problem who just has depression, new research suggests.

Psychologists at Duke University Medical Center in Durham, N.C., followed more than 900 patients with heart disease for more than four years, including 325 with Type 2 diabetes.

"We found a trend showing that the probability of death increases as the level of depression increases in diabetic patients with coronary artery disease," said Duke researcher Anastasia Georgiades, who presented the findings on Friday at the annual meeting of the American Psychosomatic Society in Budapest.

After controlling for heart disease severity and age, patients with both conditions were still at higher risk of dying. There were 135 deaths during the study.

Doctors should closely monitor heart patients with both disorders, asthe combined effect is not fully understood, Georgiades said.

Less motivated?

People with Type 2 diabetes may need to follow special diets, take medications, exercise and keep appointments with their doctors. It could be that people with depression and Type 2 diabetes take poorer care of themselves, the researchers speculated.

"It may be that such patients who are depressed might not be as motivated to carry out all these activities, thereby putting them at higher risk."

Depression in people with diabetes is linked with poorer metabolic control and long-term complications, as well as other risk factors for heart disease such as hypertension, obesity and cigarette smoking.

Medications used to treat depression and the chemical changes in the body associated with the condition could also play a role.

Obesity is the main risk factor for Type 2 diabetes, in which weight gain, poor nutrition and lack of exercise reduce the body's ability to use insulin to control levels of sugar.

Type 1 diabetes occurs when the body makes little or no insulin and is normally treated through insulin injections.