Blood sugar swings tied to depression in elderly with type 2 diabetes

Greater changes of haemoglobin A1C (HbA1c), a marker of long-term blood sugar levels, are associated with a number of symptoms for depression in elderly individuals with type 2 diabetes, a recent Israeli study finds.

“The results suggest that maintaining stability in glycaemia (‘blood sugar’) control may be important for prevention of depressive symptoms in elderly diabetic patients,” Dr.Ramit Ravona told Reuters Health.

People with type 2 diabetes are twice likely as people without diabetes to develop depression, which affects third of individuals 65 years and older. Variability in HbA1c has been associated with complications of diabetes, but there is little information about its relationship with depression.

Ravona team analyzed about nine years’ worth of data on 837 people with type 2 diabetes whose average age was nearly 73 years. The information included 18 HbA1c measurements over the years for each participant, and results from a depression assessment at the start of the study period.

The variability of HbA1c measurements was, such that each 1 percent increase in variability was associated with a 29 percent increase in the number of depressive symptoms, researchers found.

The relationship between HbA1c variability was true and it was strongest among people whose HbA1c was above 7 percent, a common target for blood sugar control.

The researchers admit that the results just show an association and do not necessarily mean that blood sugar variability causes symptoms of depression. More consistent blood sugar control - might help to prevent depression in elderly people with type 2 diabetes.

“This study is ongoing,” Ravona-Springer said. “We thus expect to have even better understanding of the directional relationships of glycaemia control and other diabetes-related characteristics with depression as we start analyzing longitudinal data,” she said in an email.

"The study hints at the importance of achieving stable A1c values at a certain age/point in a patient‘s diabetes history in contrast to trying to reduce A1c,” said Dr. Dominic Ehrmann, who has also studied the link between depression and diabetes.“Depression/depressive symptoms should be an important factor in clinical decision making in elderly patients,” concluded Ehrmann.