The Burden of Comorbid Depression and Type 2 Diabetes: An Empirical Study Using Commercial Insurance Data

Introduction: Despite rising rates of depression and diabetes, assessments of depression’s burden on diabetes management and its economic burden remain limited. In this study, we evaluate the burden of depression on diabetes management and quantify the financial implications of comorbid depression a...

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Main Authors: SangNam Ahn, Gang Han, McKenzie Beck, Wan-Ling Hsu, Samuel D. Towne, Matthew Lee Smith, Marcia G. Ory
Format: Article
Language:English
Published: SAGE Publishing 2025-05-01
Series:Journal of Primary Care & Community Health
Online Access:https://doi.org/10.1177/21501319251336629
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author SangNam Ahn
Gang Han
McKenzie Beck
Wan-Ling Hsu
Samuel D. Towne
Matthew Lee Smith
Marcia G. Ory
author_facet SangNam Ahn
Gang Han
McKenzie Beck
Wan-Ling Hsu
Samuel D. Towne
Matthew Lee Smith
Marcia G. Ory
author_sort SangNam Ahn
collection DOAJ
description Introduction: Despite rising rates of depression and diabetes, assessments of depression’s burden on diabetes management and its economic burden remain limited. In this study, we evaluate the burden of depression on diabetes management and quantify the financial implications of comorbid depression and diabetes. Methods: We performed propensity score matching on Texas commercial claims data (2016-2019) to match type 2 diabetes patients with depression (n = 613) to those without (n = 583). Depression flagged in 2016/2017 indicated initial depression, and an A1C level of ≥8% in 2018/2019 indicated follow-up uncontrolled diabetes. Healthcare costs included total, diabetes-related, outpatient, and inpatient costs incurred during 2018/2019. Results: A depression flag in the initial period was linked to a 2.7 percentage point increase ( P  = .031) in the probability of having an A1C level of ≥8% in the follow-up, compared to individuals without a depression flag. Having both a depression flag and uncontrolled A1C in the initial period was associated with $2,037 higher total medical costs ( P  = .004), $494 higher diabetes-related costs ( P  = .020), and $336 higher outpatient costs ( P  = .008) in the follow-up, compared to the respective averages of $6,900, $474, and $583 for individuals without a depression flag or uncontrolled A1C. Conclusions: Our findings highlight the detrimental effect of depression on uncontrolled diabetes and the subsequent increase in healthcare costs. Further research is warranted to determine the effectiveness of proactive treatments for depression in managing diabetes, improving glycemic control, and reducing healthcare costs.
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spelling doaj-art-9c52fd37acc045a4aceb357eba0eac0a2025-08-20T02:15:20ZengSAGE PublishingJournal of Primary Care & Community Health2150-13272025-05-011610.1177/21501319251336629The Burden of Comorbid Depression and Type 2 Diabetes: An Empirical Study Using Commercial Insurance DataSangNam Ahn0Gang Han1McKenzie Beck2Wan-Ling Hsu3Samuel D. Towne4Matthew Lee Smith5Marcia G. Ory6Texas A&M University School of Public Health Center for Health and Aging, College Station, TX, USATexas A&M University School of Public Health Department of Epidemiology and Biostatistics, College Station, TX, USASaint Louis University College for Public Health and Social Justice Department of Health Policy and Management, Saint Louis, MO, USASaint Louis University College for Public Health and Social Justice Department of Health Policy and Management, Saint Louis, MO, USATexas A&M University School of Public Health Department of Environmental and Occupational Health, College Station, TX, USATexas A&M University School of Public Health Department of Health Behavior, College Station, TX, USATexas A&M University School of Public Health Department of Environmental and Occupational Health, College Station, TX, USAIntroduction: Despite rising rates of depression and diabetes, assessments of depression’s burden on diabetes management and its economic burden remain limited. In this study, we evaluate the burden of depression on diabetes management and quantify the financial implications of comorbid depression and diabetes. Methods: We performed propensity score matching on Texas commercial claims data (2016-2019) to match type 2 diabetes patients with depression (n = 613) to those without (n = 583). Depression flagged in 2016/2017 indicated initial depression, and an A1C level of ≥8% in 2018/2019 indicated follow-up uncontrolled diabetes. Healthcare costs included total, diabetes-related, outpatient, and inpatient costs incurred during 2018/2019. Results: A depression flag in the initial period was linked to a 2.7 percentage point increase ( P  = .031) in the probability of having an A1C level of ≥8% in the follow-up, compared to individuals without a depression flag. Having both a depression flag and uncontrolled A1C in the initial period was associated with $2,037 higher total medical costs ( P  = .004), $494 higher diabetes-related costs ( P  = .020), and $336 higher outpatient costs ( P  = .008) in the follow-up, compared to the respective averages of $6,900, $474, and $583 for individuals without a depression flag or uncontrolled A1C. Conclusions: Our findings highlight the detrimental effect of depression on uncontrolled diabetes and the subsequent increase in healthcare costs. Further research is warranted to determine the effectiveness of proactive treatments for depression in managing diabetes, improving glycemic control, and reducing healthcare costs.https://doi.org/10.1177/21501319251336629
spellingShingle SangNam Ahn
Gang Han
McKenzie Beck
Wan-Ling Hsu
Samuel D. Towne
Matthew Lee Smith
Marcia G. Ory
The Burden of Comorbid Depression and Type 2 Diabetes: An Empirical Study Using Commercial Insurance Data
Journal of Primary Care & Community Health
title The Burden of Comorbid Depression and Type 2 Diabetes: An Empirical Study Using Commercial Insurance Data
title_full The Burden of Comorbid Depression and Type 2 Diabetes: An Empirical Study Using Commercial Insurance Data
title_fullStr The Burden of Comorbid Depression and Type 2 Diabetes: An Empirical Study Using Commercial Insurance Data
title_full_unstemmed The Burden of Comorbid Depression and Type 2 Diabetes: An Empirical Study Using Commercial Insurance Data
title_short The Burden of Comorbid Depression and Type 2 Diabetes: An Empirical Study Using Commercial Insurance Data
title_sort burden of comorbid depression and type 2 diabetes an empirical study using commercial insurance data
url https://doi.org/10.1177/21501319251336629
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