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Meta-Analysis
. 2018 Nov 28;8(11):e020062.
doi: 10.1136/bmjopen-2017-020062.

The association between insulin therapy and depression in patients with type 2 diabetes mellitus: a meta-analysis

Xiaosu Bai  1 , Zhiming Liu  1 , Zhisen Li  1 , Dewen Yan  2
Affiliations
Meta-Analysis

The association between insulin therapy and depression in patients with type 2 diabetes mellitus: a meta-analysis

Xiaosu Bai et al. BMJ Open. .

Abstract

Objectives: Several patients with type 2 diabetes mellitus (T2DM) have depressive disorders. Whether insulin treatment was associated with increased risk of depression remains controversial. We performed a meta-analysis to evaluate the association of insulin therapy and depression.

Design: A meta-analysis.

Methods: We conducted a systematic search of PubMed, PsycINFO, Embase and the Cochrane Library from their inception to April 2016. Epidemiological studies comparing the prevalence of depression between insulin users and non-insulin users were included. A random-effects model was used for meta-analysis. The adjusted and crude data were analysed.

Results: Twenty-eight studies were included. Of these, 12 studies presented with adjusted ORs. Insulin therapy was significantly associated with increased risk of depression (OR=1.41, 95% CI 1.13 to 1.76, p=0.003). Twenty-four studies provided crude data. Insulin therapy was also associated with an odds for developing depression (OR=1.59, 95% CI 1.41 to 1.80, p<0.001). When comparing insulin therapy with oral antidiabetic drugs, significant association was observed for adjusted (OR=1.42, 95% CI 1.08 to 1.86, p=0.008) and crude (OR=1.61, 95% CI 1.35 to 1.93, p<0.001) data.

Conclusions: Our meta-analysis confirmed that patients on insulin therapy were significantly associated with the risk of depressive symptoms.

Keywords: depression; insulin; meta-analysis; risk factor; type 2 diabetes mellitus.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
The selection process for eligible studies.
Figure 2
Figure 2
The pooled adjusted OR for the risk of depression in insulin-prescribed patients compared with those without insulin therapy.
Figure 3
Figure 3
The pooled crude OR for the risk of depression in insulin-prescribed patients compared with those without insulin therapy.
Figure 4
Figure 4
The funnel plot for studies reporting adjusted ORs. s.e. of lnrr, standard error of lnrr.
Figure 5
Figure 5
The funnel plot for studies presenting crude ORs.
See this image and copyright information in PMC

References

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