Insulin Resistance in People Linked to Major Depressive Disorder

A study published in September 2021 in the American Journal of Psychiatry suggests that people with insulin resistance—who were earlier considered susceptible to develop type-2 diabetes—may also have an increased risk of developing major depressive disorder. Elevated blood glucose levels, high triglycerides and a large waist circumference are predictive of a depression diagnosis in people without any prior history of mood disorders.

Statistics suggest that every one in five Americans experiences a major depressive disorder at some point in their lifetime. They experience symptoms like despair, unremitting sadness, sleep disturbance, sluggishness and loss of appetite. Some factors that compound this deeply debilitating disease are loss of a loved one, childhood traumas, and other stressors. However, depression caused by insulin resistance can be prevented. It can be alleviated by exercise, diet and medication.

The study, conducted by researchers at Stanford University School of Medicine in California, looked at 601 healthy adults who were tested for three parameters of insulin resistance—waist circumference, blood sugar levels, and triglycerides (levels of fats) in the blood. These three components are known to exacerbate risk of heart disease. The study included white participants of Northern European ancestry who were 41 years old at the start of the study. 60 percent of them were women, and 75 percent of them were married.

After nine years of follow-up they found that 14 percent of the respondents developed clinical depression. The study further suggested that people who tested positive for any of the substitute for insulin resistance were at a higher risk of developing depression.

People who had lower levels of good cholesterol known as HDL (that helps to remove artery blockage) and higher levels of triglycerides had 89 percent greater risk of developing depression during the study period. Every two-inch increase in the waist circumference was associated with 11 percent greater depression risk. While, per 18 mg/DL rise in fasting blood sugar levels was associated with 37 percent higher risk of depression.

But, in case of people who were not diagnosed with any of the possibility of insulin resistance, the rise in their blood sugar levels were considered as pre-diabetics and were associated with 2.7 fold greater risk of depression.

What role does insulin play in the body?

Insulin is a hormone produced by beta cells of pancreases responsible for breaking down the blood sugar levels and maintaining an appropriate glucose level in the blood, which is the body’s source of energy. With insulin resistance, body does not use insulin properly and give rise to a condition called hyperglycemia, which leads to accumulation of sugar in the blood. When pancreas is not able to secrete enough insulin to break down the blood sugar level it leads to type-2 diabetes.

The study was not designed to link diabetes with depression. However they unearthed results that revealed factors like stress and poor sleep can trigger both, diabetes and depression.

Nevertheless, there were several limitations of this study, such as direct insulin tests were not used to determine the actual functionality of the hormone. Proxy measures can provide a good understanding of connection between insulin resistance and depression, but they don’t provide a concrete evidence for the same. Further research is needed to provide support to the findings.

There were prior studies that tried to establish a link between insulin resistance and depression. One such study was published in August 2020 in Diabetologia and the other was published in November 2017 in PLoS One.

There were also studies done to investigate whether lowering of blood sugar level can help treat depression or medication used to treat diabetes can be used as anti-depressant. A study published in June 2020 in Neurotherapeutics tried to find a solution of treating depression using diabetes medication.

It showed that 81 percent of people who were treated with antidepressants and anti-diabetic medication such as metformin experienced remission in symptoms of depression compared to 46 percent of patients who took an antidepressant alone.

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