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Cerebrovascular Origin for Depression in T1D?

Diabet Med; ePub 2018 Dec 15; Nunley, et al

Findings from a recent study suggest a cerebrovascular origin for depressive symptoms in adults with type 1 diabetes (T1D), perhaps triggered by hyperglycemia. Depressive symptoms and white matter hyperintensities were compared between adults (age range 30–65 years) with juvenile‐onset T1D (n=130) and adults without T1D (n=133). The association of T1D with depression was computed before and after adjustment for white matter hyperintensities. Among the T1D group, the primary associations of interest were between depressive symptoms (Beck Depression Inventory score ≥10) and white matter hyperintensities (n=71), hyperglycemia, and physical activity. Associations between depressive symptoms and diabetes‐related complications, cognitive impairment, smoking, and self‐reported disability were examined. They found:

  • Depressive symptoms were more prevalent among those with vs those without T1D (28% vs 3%).
  • White matter hyperintensities explained 40% of the association of T1D with depressive symptoms, while T1D had a direct effect of 68% on depressive symptoms.
  • Among those with T1D, depressive symptoms were related to white matter hyperintensity volume, a 16‐year average HbA1c ≥58 mmol/mol (7.5%), and lower physical activity levels.
  • Associations with other characteristics were not significant.


Nunley KA, Karp JF, Orchard T, et al. Depressive symptoms and cerebral microvascular disease in adults with type 1 diabetes mellitus. [Published online ahead of print December 15, 2018]. Diabet Med. doi:10.1111/dme.13879.