Study reveals how depression impacts diabetes risk

Research carried out by scientists from Saint Louis University revealed that individuals suffering from depression had a higher chance of developing poorly managed diabetes over time, and that depression increases the financial strain associated with managing diabetes.

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The study, published in the Primary Care and Community Health Journal is derived from commercial insurance claims data following 1,196 individuals diagnosed with type 2 diabetes, comparing those who received a clinical diagnosis of depression with those who did not.

The data reveal a concerning connection," stated SangNam Ahn, Ph.D., primary investigator and assistant professor of health management and policy at SLU. "Individuals suffering from depression tended to experience less regulated glucose levels over time when contrasted with those without depressive symptoms.

Health experts frequently rely on insurance claims information to gain insights about how common, severe, and complicated various health issues are. Along with highlighting the impact of an illness on both health and overall well-being, this type of data can also show the economic strain associated with a particular condition.

This research analyzed insurance records from Texas over four years, from 2016 through 2019. It revealed that people who had both depression and poorly managed type 2 diabetes incurred $2,037 more overall healthcare expenses, $494 greater costs specifically related to diabetes, and $336 additional out-of-pocket spending than those without these health issues.

Our research showed that people who had depression during the initial phase of our study were much more prone to having poorly managed A1C levels several years down the line," Ahn stated. "This might be due to depression and associated challenges in following diabetes care guidelines.

Notably, scientists point out that depression and diabetes have overlapping biological foundations. Each condition is characterized by excessive activation of the immune system, potentially resulting in inflammation and disruption of the HPA axis. This could lead to elevated cortisol levels, reducing the body’s ability to respond effectively to insulin. Prolonged high cortisol levels, found in half of individuals experiencing depression, might increase the risk of developing diabetes. Moreover, poor dietary habits and insufficient physical activity can be contributing factors for both conditions.

Moreover, although the research focuses on individuals with commercial health insurance, Ahn points out that the physical and financial strains associated with having both diabetes and depression are more severe among those who lack coverage. Without insurance, people face restricted access to regular medical care, leading to increased reliance on emergency room visits and postponed treatments, which in turn increases overall system expenses and deteriorates patient health.

Ahn pointed out that the division between mental and physical healthcare services, along with payment systems that focus on reacting rather than preventing issues early, create shortcomings leading to disjointed care and greater expenses over time. He supports incorporating mental health within managing long-term illnesses using team-based approaches and broadening coverage for identifying and addressing depression. Important actions involve enhancing availability of medical services, funding local mental health facilities, and boosting remote healthcare accessibility.

More information: SangNam Ahn and colleagues, The Impact of Concurrent Depression and Type 2 Diabetes: A Research Analysis Based on Commercial Health Insurance Records, Primary Care and Community Health Journal (2025). DOI: 10.1177/21501319251336629

Supplied by Saint Louis University

This narrative first appeared on Medical Xpress .