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Antidepressant medication as a risk factor for Type 2 Diabetes and impaired glucose regulation

Antidepressant medication as a risk factor for Type 2 Diabetes and impaired glucose regulation
Antidepressant medication as a risk factor for Type 2 Diabetes and impaired glucose regulation
OBJECTIVE Antidepressant use has risen sharply over recent years. Recent concerns that antidepressants may adversely affect glucose metabolism require investigation. Our aim was to assess the risk of type 2 diabetes associated with antidepressants through a systematic review.

RESEARCH DESIGN AND METHODS Data sources were MEDLINE, Embase, PsycINFO, The Cochrane Library, Web of Science, meeting abstracts of the European Association for the Study of Diabetes, American Diabetes Association, and Diabetes UK, Current Controlled Trials, ClinicalTrials.gov, U.K. Clinical Research Network, scrutiny of bibliographies of retrieved articles, and contact with relevant experts. Relevant studies of antidepressant effects were included. Key outcomes were diabetes incidence and change in blood glucose (fasting and random).

RESULTS Three systemic reviews and 22 studies met the inclusion criteria. Research designs included 1 case series and 21 observational studies comprising 4 cross-sectional, 5 case-control, and 12 cohort studies. There was evidence that antidepressant use is associated with type 2 diabetes. Causality is not established, but rather, the picture is confused, with some antidepressants linked to worsening glucose control, particularly with higher doses and longer duration, others linked with improved control, and yet more with mixed results. The more recent, larger studies, however, suggest a modest effect. Study quality was variable.

CONCLUSIONS Although evidence exists that antidepressant use may be an independent risk factor for type 2 diabetes, long-term prospective studies of the effects of individual antidepressants rather than class effects are required. Heightened alertness to potential risks is necessary until these are complete.
1935-5548
3337-3345
Barnard, K.
1ade2840-48a4-4bb3-b564-0a058df8297f
Peveler, R.C.
93198224-78d9-4c1f-9c07-fdecfa69cf96
Holt, R.I.G.
d54202e1-fcf6-4a17-a320-9f32d7024393
Barnard, K.
1ade2840-48a4-4bb3-b564-0a058df8297f
Peveler, R.C.
93198224-78d9-4c1f-9c07-fdecfa69cf96
Holt, R.I.G.
d54202e1-fcf6-4a17-a320-9f32d7024393

Barnard, K., Peveler, R.C. and Holt, R.I.G. (2013) Antidepressant medication as a risk factor for Type 2 Diabetes and impaired glucose regulation. Diabetes Care, 36 (10), 3337-3345. (doi:10.2337/dc13-0560).

Record type: Article

Abstract

OBJECTIVE Antidepressant use has risen sharply over recent years. Recent concerns that antidepressants may adversely affect glucose metabolism require investigation. Our aim was to assess the risk of type 2 diabetes associated with antidepressants through a systematic review.

RESEARCH DESIGN AND METHODS Data sources were MEDLINE, Embase, PsycINFO, The Cochrane Library, Web of Science, meeting abstracts of the European Association for the Study of Diabetes, American Diabetes Association, and Diabetes UK, Current Controlled Trials, ClinicalTrials.gov, U.K. Clinical Research Network, scrutiny of bibliographies of retrieved articles, and contact with relevant experts. Relevant studies of antidepressant effects were included. Key outcomes were diabetes incidence and change in blood glucose (fasting and random).

RESULTS Three systemic reviews and 22 studies met the inclusion criteria. Research designs included 1 case series and 21 observational studies comprising 4 cross-sectional, 5 case-control, and 12 cohort studies. There was evidence that antidepressant use is associated with type 2 diabetes. Causality is not established, but rather, the picture is confused, with some antidepressants linked to worsening glucose control, particularly with higher doses and longer duration, others linked with improved control, and yet more with mixed results. The more recent, larger studies, however, suggest a modest effect. Study quality was variable.

CONCLUSIONS Although evidence exists that antidepressant use may be an independent risk factor for type 2 diabetes, long-term prospective studies of the effects of individual antidepressants rather than class effects are required. Heightened alertness to potential risks is necessary until these are complete.

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Published date: October 2013
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 353722
URI: https://eprints.soton.ac.uk/id/eprint/353722
ISSN: 1935-5548
PURE UUID: 2454bc3a-6698-41fc-b48d-41891f2de26b
ORCID for R.C. Peveler: ORCID iD orcid.org/0000-0001-5596-9394
ORCID for R.I.G. Holt: ORCID iD orcid.org/0000-0001-8911-6744

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Date deposited: 17 Jun 2013 08:57
Last modified: 06 Jun 2018 13:13

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Contributors

Author: K. Barnard
Author: R.C. Peveler ORCID iD
Author: R.I.G. Holt ORCID iD

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