Poster Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2014

High baseline prevalence of depression and elevated HbA1c in patients with acute coronary syndrome: a report from the ADVENT study (#387)

John Oldroyd 1 2 , Dominique Bird 2 3 , Brian Oldenburg 1
  1. University of Melbourne, Melbourne, VIC, Australia
  2. School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
  3. Centre for Online Health, The University of Queensland, Queensland, Australia

Having T2DM more than doubles the risk of developing depression (1) and ~45% of people with T2DM have undiagnosed depression (2). Individually, depression and T2DM are both very disabling conditions, and when they occur comorbidly, the costs, morbidity and mortality increase significantly. T2DM and depression have a bi-directional relationship, with each condition being an independent risk factor for the development and progression of the other (3). Depression is associated with poor blood glucose control in T2DM (4) and an increased risk for diabetic complications. However, it is unclear how blood glucose control, assessed by HbA1c, is related to depression and what is the role of depression in blood glucose control in those with less severe metabolic dysfunction such as impaired fasting glucose. We are prospectively investigating the association between blood glucose control and depression in acute coronary syndrome patients over 12 month’s follow-up (ADVENT, NHMRC APP 1021294). Here, we hypothesised that at baseline: 1) the prevalence and severity of depression would be higher/worse in those with elevated glycosylated haemoglobin (HbA1c) compared to those with impaired fasting glucose (IFG) and 2) fasting plasma glucose (FPG) and HbA1c would be positively associated with depression scores. Of 324 participants for whom we have clinical baseline data, 81 (25.0%) had elevated HbA1c (HbA1c ≥ 6.5%); 20 (6.2%) had IFG (FPG 6.1-6.9mmol/l); 149 (46.0%) met criteria for major depressive disorder (MDD) (Cardiac Depression Scale score (CDS) >= 95). Of those with elevated HbA1c, 36 (44.4 %) met criteria for MDD. Of those with IFG, 6 (30.0 %) met criteria for MDD. FPG and HbA1c were not associated with CDS or Beck Depression Inventory scores. Our results suggest a high prevalence of depression and elevated HbA1c in patients with acute coronary syndrome. These results warrant further investigation.

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