Is the Presence of a Depressive Disorder a Risk Factor for Worse Metabolic Outcomes Among Patients with Type 2 Diabetes Treated with GLP-1 Analogs?
Background/Objectives: Type 2 diabetes mellitus (T2DM) is frequently associated with depressive disorder (DD), which negatively impacts glycemic control and overall metabolic outcomes. Recent evidence suggests that glucagon-like peptide-1 receptor agonists (GLP-1 RAs) may exert neuroprotective effec...
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MDPI AG
2025-07-01
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| Series: | Diabetology |
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| Online Access: | https://www.mdpi.com/2673-4540/6/7/68 |
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| author | Joana Nicolau Pilar Sanchís María Isabel Tamayo Guadalupe Pérez-Bec Guido Sfondrini Mireia Grimalt Lluís Masmiquel |
| author_facet | Joana Nicolau Pilar Sanchís María Isabel Tamayo Guadalupe Pérez-Bec Guido Sfondrini Mireia Grimalt Lluís Masmiquel |
| author_sort | Joana Nicolau |
| collection | DOAJ |
| description | Background/Objectives: Type 2 diabetes mellitus (T2DM) is frequently associated with depressive disorder (DD), which negatively impacts glycemic control and overall metabolic outcomes. Recent evidence suggests that glucagon-like peptide-1 receptor agonists (GLP-1 RAs) may exert neuroprotective effects and modulate mood. Likewise, it is unknown whether the presence of a DD, due to increased brain inflammation, could lead to a poorer response to GLP-1 RAs in terms of weight loss. This study evaluates the impact of DD on metabolic outcomes in individuals treated with GLP-1 RAs. Methods: We conducted a retrospective longitudinal study including 115 patients with T2DM treated with GLP-1 RAs for at least six months. DD was identified based on a documented clinical diagnosis, chronic antidepressant use, or a Beck Depression Inventory (BDI) score ≥16. Metabolic parameters, including glycated hemoglobin (HbA1c), fasting glucose, the body mass index (BMI), the waist circumference, and triglycerides, were compared between patients with and without DD. Results: Patients with DD had significantly higher baseline HbA1c (7.5% vs. 6.9%, <i>p</i> = 0.01), fasting glucose, and triglyceride levels. The waist circumference was also higher in the DD group (<i>p</i> = 0.001). However, no significant differences were observed in weight loss or BMI reductions following the GLP-1 RA treatment. Final HbA1c levels remained higher in the DD group (7.2% vs. 7.0%, <i>p</i> = 0.01). Conclusions: While DD is associated with a poorer baseline metabolic control in T2DM, it does not appear to impair the weight loss efficacy with GLP-1 RAs. However, patients with DD maintain higher post-treatment HbA1c levels, underscoring the need for integrated metabolic and psychiatric care in diabetes management. |
| format | Article |
| id | doaj-art-c0f6a4a45fec4a28b4e551c393475f10 |
| institution | Kabale University |
| issn | 2673-4540 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diabetology |
| spelling | doaj-art-c0f6a4a45fec4a28b4e551c393475f102025-08-20T03:58:26ZengMDPI AGDiabetology2673-45402025-07-01676810.3390/diabetology6070068Is the Presence of a Depressive Disorder a Risk Factor for Worse Metabolic Outcomes Among Patients with Type 2 Diabetes Treated with GLP-1 Analogs?Joana Nicolau0Pilar Sanchís1María Isabel Tamayo2Guadalupe Pérez-Bec3Guido Sfondrini4Mireia Grimalt5Lluís Masmiquel6Vascular and Metabolic Diseases Research Group, Endocrinology Department, Health Research Institute of the Balearic Islands (IdISBa), Son Llàtzer University Hospital, 07198 Palma de Mallorca, SpainVascular and Metabolic Diseases Research Group, Endocrinology Department, Health Research Institute of the Balearic Islands (IdISBa), Son Llàtzer University Hospital, 07198 Palma de Mallorca, SpainVascular and Metabolic Diseases Research Group, Endocrinology Department, Health Research Institute of the Balearic Islands (IdISBa), Son Llàtzer University Hospital, 07198 Palma de Mallorca, SpainVascular and Metabolic Diseases Research Group, Endocrinology Department, Health Research Institute of the Balearic Islands (IdISBa), Son Llàtzer University Hospital, 07198 Palma de Mallorca, SpainVascular and Metabolic Diseases Research Group, Endocrinology Department, Health Research Institute of the Balearic Islands (IdISBa), Son Llàtzer University Hospital, 07198 Palma de Mallorca, SpainVascular and Metabolic Diseases Research Group, Endocrinology Department, Health Research Institute of the Balearic Islands (IdISBa), Son Llàtzer University Hospital, 07198 Palma de Mallorca, SpainVascular and Metabolic Diseases Research Group, Endocrinology Department, Health Research Institute of the Balearic Islands (IdISBa), Son Llàtzer University Hospital, 07198 Palma de Mallorca, SpainBackground/Objectives: Type 2 diabetes mellitus (T2DM) is frequently associated with depressive disorder (DD), which negatively impacts glycemic control and overall metabolic outcomes. Recent evidence suggests that glucagon-like peptide-1 receptor agonists (GLP-1 RAs) may exert neuroprotective effects and modulate mood. Likewise, it is unknown whether the presence of a DD, due to increased brain inflammation, could lead to a poorer response to GLP-1 RAs in terms of weight loss. This study evaluates the impact of DD on metabolic outcomes in individuals treated with GLP-1 RAs. Methods: We conducted a retrospective longitudinal study including 115 patients with T2DM treated with GLP-1 RAs for at least six months. DD was identified based on a documented clinical diagnosis, chronic antidepressant use, or a Beck Depression Inventory (BDI) score ≥16. Metabolic parameters, including glycated hemoglobin (HbA1c), fasting glucose, the body mass index (BMI), the waist circumference, and triglycerides, were compared between patients with and without DD. Results: Patients with DD had significantly higher baseline HbA1c (7.5% vs. 6.9%, <i>p</i> = 0.01), fasting glucose, and triglyceride levels. The waist circumference was also higher in the DD group (<i>p</i> = 0.001). However, no significant differences were observed in weight loss or BMI reductions following the GLP-1 RA treatment. Final HbA1c levels remained higher in the DD group (7.2% vs. 7.0%, <i>p</i> = 0.01). Conclusions: While DD is associated with a poorer baseline metabolic control in T2DM, it does not appear to impair the weight loss efficacy with GLP-1 RAs. However, patients with DD maintain higher post-treatment HbA1c levels, underscoring the need for integrated metabolic and psychiatric care in diabetes management.https://www.mdpi.com/2673-4540/6/7/68type 2 diabetesdepressive disorderGLP-1 analogBMIHbA1c |
| spellingShingle | Joana Nicolau Pilar Sanchís María Isabel Tamayo Guadalupe Pérez-Bec Guido Sfondrini Mireia Grimalt Lluís Masmiquel Is the Presence of a Depressive Disorder a Risk Factor for Worse Metabolic Outcomes Among Patients with Type 2 Diabetes Treated with GLP-1 Analogs? Diabetology type 2 diabetes depressive disorder GLP-1 analog BMI HbA1c |
| title | Is the Presence of a Depressive Disorder a Risk Factor for Worse Metabolic Outcomes Among Patients with Type 2 Diabetes Treated with GLP-1 Analogs? |
| title_full | Is the Presence of a Depressive Disorder a Risk Factor for Worse Metabolic Outcomes Among Patients with Type 2 Diabetes Treated with GLP-1 Analogs? |
| title_fullStr | Is the Presence of a Depressive Disorder a Risk Factor for Worse Metabolic Outcomes Among Patients with Type 2 Diabetes Treated with GLP-1 Analogs? |
| title_full_unstemmed | Is the Presence of a Depressive Disorder a Risk Factor for Worse Metabolic Outcomes Among Patients with Type 2 Diabetes Treated with GLP-1 Analogs? |
| title_short | Is the Presence of a Depressive Disorder a Risk Factor for Worse Metabolic Outcomes Among Patients with Type 2 Diabetes Treated with GLP-1 Analogs? |
| title_sort | is the presence of a depressive disorder a risk factor for worse metabolic outcomes among patients with type 2 diabetes treated with glp 1 analogs |
| topic | type 2 diabetes depressive disorder GLP-1 analog BMI HbA1c |
| url | https://www.mdpi.com/2673-4540/6/7/68 |
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