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...

Full description

Saved in:
Bibliographic Details
Main Authors: Joana Nicolau, Pilar Sanchís, María Isabel Tamayo, Guadalupe Pérez-Bec, Guido Sfondrini, Mireia Grimalt, Lluís Masmiquel
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Diabetology
Subjects:
Online Access:https://www.mdpi.com/2673-4540/6/7/68
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849246579473514496
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
work_keys_str_mv AT joananicolau isthepresenceofadepressivedisorderariskfactorforworsemetabolicoutcomesamongpatientswithtype2diabetestreatedwithglp1analogs
AT pilarsanchis isthepresenceofadepressivedisorderariskfactorforworsemetabolicoutcomesamongpatientswithtype2diabetestreatedwithglp1analogs
AT mariaisabeltamayo isthepresenceofadepressivedisorderariskfactorforworsemetabolicoutcomesamongpatientswithtype2diabetestreatedwithglp1analogs
AT guadalupeperezbec isthepresenceofadepressivedisorderariskfactorforworsemetabolicoutcomesamongpatientswithtype2diabetestreatedwithglp1analogs
AT guidosfondrini isthepresenceofadepressivedisorderariskfactorforworsemetabolicoutcomesamongpatientswithtype2diabetestreatedwithglp1analogs
AT mireiagrimalt isthepresenceofadepressivedisorderariskfactorforworsemetabolicoutcomesamongpatientswithtype2diabetestreatedwithglp1analogs
AT lluismasmiquel isthepresenceofadepressivedisorderariskfactorforworsemetabolicoutcomesamongpatientswithtype2diabetestreatedwithglp1analogs