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
Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved..
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:209 |
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| Enthalten in: |
Diabetes research and clinical practice - 209(2024) vom: 22. März, Seite 111083 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Jeffery, Annie [VerfasserIn] |
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| Links: |
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| Themen: |
Antidepressant |
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| Anmerkungen: |
Date Completed 25.03.2024 Date Revised 25.03.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.diabres.2023.111083 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
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| 100 | 1 | |a Jeffery, Annie |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The association between antidepressant treatment and rates of insulin initiation in comorbid depression and type 2 diabetes |b A UK electronic health record nested case-control study |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Completed 25.03.2024 | ||
| 500 | |a Date Revised 25.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved. | ||
| 520 | |a AIMS: To investigate the association between antidepressant prescribing and the rate of insulin initiation in type 2 diabetes | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Antidepressant | |
| 650 | 4 | |a Depression | |
| 650 | 4 | |a Epidemiology | |
| 650 | 4 | |a Insulin therapy | |
| 650 | 4 | |a Long-term outcomes | |
| 650 | 4 | |a Primary Care | |
| 650 | 4 | |a Type 2 Diabetes | |
| 650 | 7 | |a Insulin |2 NLM | |
| 650 | 7 | |a Antidepressive Agents |2 NLM | |
| 650 | 7 | |a Insulin, Regular, Human |2 NLM | |
| 700 | 1 | |a Walters, Kate |e verfasserin |4 aut | |
| 700 | 1 | |a Wong, Ian C K |e verfasserin |4 aut | |
| 700 | 1 | |a Osborn, David |e verfasserin |4 aut | |
| 700 | 1 | |a Hayes, Joseph F |e verfasserin |4 aut | |
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