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Research ArticleOriginal Research

Depression and Increased Mortality in Diabetes: Unexpected Causes of Death

Elizabeth H. B. Lin, Susan R. Heckbert, Carolyn M. Rutter, Wayne J. Katon, Paul Ciechanowski, Evette J. Ludman, Malia Oliver, Bessie A. Young, David K. McCulloch and Michael Von Korff
The Annals of Family Medicine September 2009, 7 (5) 414-421; DOI: https://doi.org/10.1370/afm.998
Elizabeth H. B. Lin
MD, MPH
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Susan R. Heckbert
MD, Ph.D
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Carolyn M. Rutter
PhD
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Wayne J. Katon
MD
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Paul Ciechanowski
MD, MPH
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Evette J. Ludman
PhD
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Malia Oliver
BA
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Bessie A. Young
MD, MPH
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David K. McCulloch
MD
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Michael Von Korff
ScD
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The Article in Brief

Depression and Increased Mortality in Diabetes: Unexpected Causes of Death

Elizabeth H. B. Lin , and colleagues

Background Previous research has found that people with diabetes are more likely than others to experience depression, and that people with both diabetes and depression have higher rates of death than diabetes patients with no depression. This study examined whether depression in diabetes patients was associated mainly with death from cardiovascular disease (the focus of most research on depression and mortality since the two were first linked), or whether it was also associated with increased risks of death from other common medical causes.

What This Study Found Patients with both diabetes and depression face substantially higher risks of death beyond cardiovascular-related death.

Implications

  • Obesity, smoking, and physical inactivity are more common among patients with diabetes and depression compared with diabetes patients without depression, and may help explain the association of depression with a wide range of causes of death. Other factors contributing to higher death rates could include not taking medicines as prescribed and physiologic changes.
  • Future research on patients with diabetes and depression should aim to improve health behavior, medication adherence, and control of other medical conditions, in addition to ensuring optimal depression care.

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