Jeffery, Annie;
Walters, Kate;
Wong, Ian CK;
Osborn, David;
Hayes, Joseph F;
(2024)
The association between antidepressant treatment and rates of insulin initiation in comorbid depression and type 2 diabetes: A UK electronic health record nested case-control study.
Diabetes Research and Clinical Practice
, 209
, Article 111083. 10.1016/j.diabres.2023.111083.
Preview |
Text
1-s2.0-S016882272300846X-main.pdf - Published Version Download (806kB) | Preview |
Abstract
Aims: To investigate the association between antidepressant prescribing and the rate of insulin initiation in type 2 diabetes. // Methods: Using UK primary care records we completed a nested-case control study in a individuals with comorbid depression and type 2 diabetes. Cases were defined as individuals initiating insulin, controls were individuals remaining on oral antidiabetic medication. We used conditional logistic regression to estimate incident rate ratios (IRR) and the 95% confidence intervals (CI) for the association between antidepressant prescribing and initiating insulin. We adjusted for demographic characteristics, comorbidities, health service and previous medication use. // Results: We included 11,862 cases who initiated insulin, and 43,452 controls. Increased rates of insulin initiation were associated with any antidepressant prescription (IRR 3.78, 95% CI 3.53–4.04), longer (24+ months) durations of antidepressant treatment (IRR 5.61, 95% CI 5.23–6.03), and higher numbers (3+) of different antidepressant agents prescribed (IRR 5.72, 95% CI 5.25–6.24). There was no difference between recent and non-recent antidepressant prescriptions, or between different antidepressant agents. // Conclusions: Antidepressant prescribing was highly associated with the initiation of insulin therapy. However, this may not indicate a direct causal effect of the antidepressant medication itself, and may be a marker of more severe depression influencing diabetic control.
Archive Staff Only
 |
View Item |
