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Hemoglobin A1c Variability Predicts Symptoms of Depression in Elderly Individuals With Type 2 Diabetes

Ramit Ravona-Springer1,2, Anthony Heymann3, James Schmeidler4

  • 1The Joseph Sagol Neuroscience Center, Sheba Medical Center, Ramat Gan, Israel ramit.ravona@sheba.health.gov.il ramitrs@hotmail.com.

Diabetes Care
|June 22, 2017
PubMed

Insights

High variability in hemoglobin A1c (HbA1c) levels over time is linked to increased depressive symptoms in adults with type 2 diabetes. Managing glycemic control variability may help mitigate depression risk.

Area of Science:

  • Endocrinology
  • Psychiatry
  • Gerontology

Background:

  • Type 2 diabetes management requires consistent glycemic control, often measured by hemoglobin A1c (HbA1c).
  • Glycemic variability, specifically the standard deviation of HbA1c (HbA1c-SD), has been implicated in diabetes complications.
  • Depressive symptoms are a common comorbidity in older adults with chronic conditions like diabetes.

Purpose of the Study:

  • To investigate the association between long-term glycemic control variability and the presence of depressive symptoms.
  • To determine if HbA1c variability, independent of mean HbA1c levels, predicts depressive symptoms in older adults with type 2 diabetes.

Main Methods:

  • Utilized data from 837 participants in the Israel Diabetes and Cognitive Decline (IDCD) study.
  • Assessed depressive symptoms using the Geriatric Depression Scale (GDS).
  • Quantified glycemic control variability using the standard deviation of HbA1c measurements (HbA1c-SD) collected since 1998, analyzed via negative binomial regression.

Main Results:

  • A significant positive correlation was found between mean HbA1c and HbA1c-SD (r = 0.6625; P < 0.0001).
  • HbA1c-SD, but not mean HbA1c, was significantly associated with the number of depressive symptoms.
  • Each 1% increase in HbA1c-SD corresponded to a 1.31-fold increase in depressive symptoms (IRR = 1.31 [95% CI 1.03-1.67]; P = 0.03).

Conclusions:

  • Glycemic control variability, as measured by HbA1c-SD, is a significant predictor of depressive symptoms in older adults with type 2 diabetes.
  • These findings highlight the importance of stable glycemic control beyond average HbA1c levels for mental health in diabetic patients.
Abstract

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