The Longitudinal Effects of Depression on Diabetes

In this podcast, Sri Banerjee, MD, PhD, MPH, MAS, speaks about his research on the effects of depression on diabetes, including common physiological pathways that would explain a connection between physical and mental health, and screening tools used to monitor cases of depression. 

Additional Resource:

• Banerjee S, Huth J. Longitudinal effects of depression on diabetes: a physical-mental health connection. Ann Epidemiol. 2021;61:15. https://doi.org/10.1016/j.annepidem.2021.05.038 

Sri Banerjee, MD, PhD, MPH, MAS, is a faculty member at Walden University in the School of Health Sciences. He is a clinical biostatistician and an epidemiologist in Leola, Pennsylvania. 

TRANSCRIPTION:

Jessica Bard: Hello everyone and welcome to another installment of "Podcast360," your go‑to resource for medical news and clinical updates. I'm your moderator, Jessica Bard, with Consultant360 Specialty Network.

According to the Centers for Disease Control and Prevention, people with diabetes are 2 to 3 times more likely to have depression, compared with people without diabetes. Dr Sri Banerjee is here to speak with us about that today.

Dr Banerjee is a faculty member at the School of Health Sciences at Walden University, based in Leola, Pennsylvania. He's also a clinical biostatistician and epidemiologist.

Thank you for joining us today. Your research is titled "Longitudinal effects of depression on diabetes: a physical mental health connection.” You were looking for a way to connect and relate both physical and mental health. How did you do that in this study?

Dr Sri Banerjee: Thank you for that question. When I first got started in medical school, I was even thinking in terms of main chronic diseases. One of the major chronic diseases that I encountered, again and again, was diabetes.

Diabetes was something in primary care, is just so common. Any condition that you are thinking about, specifically, a lot of times as a comorbid condition, diabetes is there.

How was there a way to relate a major physical condition to a major mental health condition? One major mental health condition is depression. The way to relate these two, took a little bit of time to think about. In this research project, we were able to create a mathematical model.

Jessica: In your research, what participant characteristics played a role in the results that you found? For instance, what was the difference that you saw in men versus women? Was there a specific age? Tell us about the participant characteristics.

Dr Banerjee: Will do, yes. There were specific differences that we did observe. In this respondent profile, The National Health and Nutrition Examination Survey, in this there are techniques that are used to make sure that there are balanced representation of different ethnicities.

This was a diverse population between the years 1999 and 2010. In this, we were able to observe even distribution of depression, with race, with gender.

However, there were some slight differences that were observed. For instance, with obesity level, we did observe that there were higher levels of depression experienced in individuals that were obese, as compared to normal weight. That was something that was expected. In other conditions as well, we saw similar patterns.

Jessica: Is there a common physiological pathway between depression and diabetes that would explain this connection?

Dr Banerjee: Thank you for that question. As it turns out, there is one specific aspect which is inflammation, which is a potential common pathway between these two conditions.

I've started investigating inflammation, specifically, in my PhD years when I was trying to find the connection between C‑reactive protein, which is a primary inflammatory biomarker, and cardiovascular disease, cardiorenal syndrome, specifically.

Surely enough, there was a strong connection found between inflammatory biomarkers and cardiorenal syndrome, of course, going back to my medical school days in pathology, I remember my instructor telling me that inflammation is a key reaction of the body to any sort of injury.

This phenomenon of inflammation can be observed in many places. Similarly, just like inflammation, there's also conceptual connections that tie depression and diabetes.

If we think about life course epidemiology and think about all of the different types of exposures in utero, that the person experiences, this can be also another source that can connect to these two conditions.

Jessica: In your research, you talked about screening tools, what are the key takeaways here for healthcare practitioners in relation to mental health? What types of screening tools can be used to monitor and identify cases of depression?

Dr Banerjee: I'll take that question one at a time. First of all, this research is useful for practitioners, because it shows the importance of trying to keep an eye out for depression. In patient encounters, it's important to understand what types of mental health issues the person may be experiencing.

Additionally, at a population health level, at a research level, it's important to also understand not only the specific mental health connections with diabetes, but also the key mental health ramifications with other chronic conditions, whether it's congestive heart failure, or other diseases specifically.

The reason I say that is because there has been a term that has been coined known as diabetes distress. This is emotional in mental health issues that are connected with diabetes specifically.

Similarly, there may be a need to create distress measures, specific to other conditions. Furthermore, other sorts of screening tools and measures that are efficient and quick, but also are accurate, are needed to be developed as it pertains to depression.

Jessica: Is there anything else you'd like to add today?

Dr Banerjee: No, I think that's it.

Jessica: Thank you so much for joining us on the podcast. We appreciate your time.

Dr Banerjee: Thank you for having me.