Positive Outcomes Associated With Regular Depression Screening in T2D

Undiagnosed depression in type 2 diabetes can lead to elevated hemoglobin A1c levels, frequent hospital admissions, and poor patient quality of life.

Annual depression screening in patients with type 2 diabetes appears to decrease negative health outcomes and may be a cost-effective way to reduce complications, according to research presented at the American Association of Nurse Practitioners (AANP) 2017 National Conference, held June 20 to 25 in Philadelphia, Pennsylvania.

After a literature review of studies examining the relationship between depression and glycemic control, Kristel McGhee, DNP, and Katherine Kenny, DNP, from the Mayo Clinic Scottsdale and Arizona State University, respectively, aimed to develop a protocol for consistent depression screening for adult patients with type 2 diabetes; secondary outcomes included evaluation of clinic staff perceptions surrounding depression screening in diabetes.

Of the 10 studies reviewed, 7 showed a “statistically significant” association between depression and inadequate glycemic control and 3 found that recognition of depressive symptoms, in conjunction with appropriate follow-up and treatment, led to improved hemoglobin A1c (HbA1c) levels.

The proposed protocol would collect baseline data, including age, sex, comorbidities, and history of depression. Patients would complete the Patient Health Questionnaire-2; patients scoring positive for depression would complete the Patient Health Questionnaire-9. After electronic documentation, clinicians should review HbA1c levels and offer either referral or treatment for depression. By following this protocol, patients with type 2 diabetes may experience fewer, and less expensive, complications, as well as lower HbA1c levels over time.

“Patients with major depressive disorder have a mean life span of 25 to 30 years less than the average person,” the researchers noted.

“[T]he purpose of this project is not only to identify and treat patients with diabetes, but also implement a sustainable process to screen these patients…for depression.”

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McGhee K, Kenny K. Depression screening and glycated hemoglobin levels: diabetes mellitus follow-up measures. Presented at: American Association of Nurse Practitioners (AANP) 2017 National Conference; June 20-25, 2017; Philadelphia, PA.