Association of antidiabetic medications with psychiatric disorders in patients with type 2 diabetes: a...

Antihyperglycemic medications can affect more than just glucose control; they may also influence mental health outcomes. This study aimed to investigate the relationships between various antidiabetic medications and psychiatric disorders, including depression, anxiety, and sleep disturbances, in individuals with type 2 diabetes (T2DM).

This cross-sectional study analyzed data from patients with T2DM, assessing psychiatric outcomes among these patients using various antidiabetic therapies. Sleep quality, anxiety, and depression were measured using validated scales, including the Pittsburgh Sleep Quality Index (PSQI), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9), respectively.

This study involved 229 patients with a mean age ± standard deviation of 63.43 ± 10.38 years. The median body mass index (BMI) was 27.18 kg/m², with an interquartile range (IQR) of 24.55-30.10, and the median duration of diabetes was 11.00 years (IQR: 6.00-16.00). The use of sodium glucose cotransporter-2 (SGLT-2) inhibitors was significantly associated with poorer sleep quality, as indicated by a higher odds ratio (odds ratio [OR] = 2.076, 95% confidence interval [CI]: 1.016-4.242, P = 0.045). Insulin use was linked to increased anxiety, with an OR of 1.985 (95% CI: 1.007-3.913, P = 0.048). In contrast, sulfonylureas and glinides were associated with lower odds of depression, with an OR of 0.374 (95% CI: 0.182-0.768, P = 0.007). No significant associations were found between thiazolidinediones, metformin, or dipeptidyl peptidase-4 (DPP-4) inhibitors and any psychiatric outcomes.

The use of SGLT2 inhibitors may negatively impact sleep quality, whereas insulin therapy is associated with increased anxiety symptoms. Conversely, sulfonylureas and glinides appear to have a protective effect against depression. These findings underscore the importance of considering psychiatric outcomes when prescribing antidiabetic medications.