Visual Abstract
Prolonged T1D and suboptimal glycemic control contributes to diabetic peripheral neuropathy, which may occur with impairing psychological symptoms. This study examined the association between neuropathy and depressive symptoms in adults with T1D.
Neuropathy was assessed using the Michigan Neuropathy Screening Instrument history and physical assessment (clinical scores >2 indicate neuropathy) in the Coronary Artery Calcification in Type 1 Diabetes (CACTI) Study. Depressive symptoms were assessed by the Beck Depression Inventory (BDI-II; scores >14 indicate clinically elevations).
Neuropathy was detected in 22% of participants with T1D (N=364; 55% female; age=51±9 years; T1D duration=38±9 years) and elevated depressive symptoms in 10%. Participants with neuropathy were older and had longer T1D duration and higher BDI-II scores; they were more likely to have elevated depressive symptoms. In logistic regression models adjusted for age, sex, T1D duration, and A1C, neuropathy was associated with a 7-fold increased odds of elevated depressive symptoms (OR [95% CI] = 7.5 [3.1-17.9, p<0.0001). It is well known that significant pain and depression result in functional impairment across various domains of daily life. Interventions to reduce clinically elevated depressive symptoms and promote adaptive coping in adults with T1D with neuropathy are largely absent, and critically needed.
S. E. Wetter: None. K. A. Driscoll: None. J. K. Snell-bergeon: Stock/Shareholder; Self; GlaxoSmithKline plc.
National Institutes of Health (R01HL113029)