Metformin treatment significantly improved depressive symptoms in people with type 2 diabetes, according to a study published today. Affective Disorders Journal.
The prevalence of type 2 diabetes (T2D) is increasing dramatically, affecting more than 400 million people worldwide. Research has demonstrated a strong association between T2D and symptoms of depression, which worsens disease outcomes. Existing treatments for depression, such as antidepressants, can worsen metabolic control, so alternative therapies that address both symptoms are needed.
Yating Yang and colleagues conducted a 24-week longitudinal study to examine whether metformin, a first-line drug for T2D, could reduce symptoms of depression.
A total of 475 participants aged 18 to 60 years with first-onset T2D and depressive symptoms were recruited from the endocrine outpatient department of Anhui Medical University Chahu Hospital from January 2021 to February 2024. Inclusion criteria required patients to meet clinical thresholds for T2D. receive a diagnosis and obtain a score of 10 or higher on the depression subscale of the Depression Anxiety Stress Scale-21 (DASS-21). Patients were excluded if they had previously used hypoglycemic drugs, antidepressants, insulin, or experienced severe diabetic complications during the study period.
Participants were divided into two groups. The group that received metformin consisted of 350 participants, and 125 participants were treated with an alternative hypoglycemic drug. Demographic and medical data, including gender, marital status, education, and presence of hypertension and dyslipidemia, were also collected.
The DASS-21 was administered at baseline and after 24 weeks to assess changes in depression, anxiety, and stress symptoms. To ensure objectivity, raters were blinded to the identity of the treatment prescribed by the participants. To monitor metabolic status during the intervention, blood samples were collected and metrics such as fasting blood glucose and glycated serum proteins were analyzed.
Yang et al. observed significant improvement in depressive symptoms in patients treated with metformin over 24 weeks. At the conclusion of the study, DASS-21 scores showed significantly reduced depression, anxiety, and stress levels in the metformin group compared to the non-metformin group. Patients receiving metformin showed a significant reduction in depression scores, from a mean of 16.01 at baseline to 12.75 at week 24. In contrast, participants in the non-metformin group had a smaller decline, with scores dropping from 15.68 to 14.84 over the same period. .
Logistic regression identified major risk factors for depression including female gender (odds ratio) [OR] = 2.04), presence of hypertension (OR = 2.67), dyslipidemia (OR = 2.44), and no metformin use (OR = 4.21).
The authors acknowledged that the DASS-21 was not consistent with ICD-10 diagnostic criteria, limiting the generalizability of the findings. Additionally, lack of randomization in treatment assignment may introduce bias.
Overall, this study highlights the dual benefits of metformin in improving glycemic control and reducing depressive symptoms in T2D patients, especially those with less complex comorbidities.
the study, “Metformin treatment improves depressive symptoms associated with type 2 diabetes: a 24-week longitudinal study” authors are Yating Yang, Xi Zhang, Yun Zhang, Jianyong Zhao, Jingfang Jia, Huanzhong Liu, and Suqi Song.
