Three different findings associated with insulin resistance and pre-diabetes are predictive of developing depression according to a study published online from the American Journal of Psychiatry.
MedPage Today (9/23/2021) writes that, “Three surrogate measures for insulin resistance all showed a significant link with developing a major depressive disorder [MDD] over a nine-year follow-up period,” researchers concluded. The 601-participant study revealed that “a higher ratio of triglycerides to high-density lipoproteins (HDLs) – 0.83 or higher for females and 1.22 or higher for males – was associated with an 89% higher risk of developing major depression.” What’s more, “individuals with prediabetes – defined as a fasting plasma glucose level of 5.54 mmol/L (100 mg/dL) or higher – saw a 37% increased risk for major depression,” and “‘central adiposity’ – defined as a waist circumference of 100 cm (39 in) or more – was associated with an 11% increased risk for depression.”
Gateway Psychiatric Best Practices
For several years we have monitored serum insulin in our patients who are at risk of developing insulin resistance and/or pre-diabetes, since increases in serum insulin correlate with insulin resistance. We also encourage our patients to take metformin (which increases insulin sensitivity and reduces weight gain in those who are taking an atypical antipsychotic) when insulin starts to increase and to consider taking a glucagon-like peptide-1 (GLP-1) agonist such as liraglutide or semaglutide if metformin is not adequately effective or poorly tolerated.
This study, and others like it, suggest that this practice not only reduces the risk of developing pre-diabetes and obesity but also may reduce the risk of a depression recurrence.
The findings were published online Sept. 23 in the American Journal of Psychiatry, a publication of the American Psychiatric Association.
Incident Major Depressive Disorder Predicted by Three Measures of Insulin Resistance: A Dutch Cohort Study Kathleen T. Watson, Julia F. Simard, Victor W. Henderson, Lexi Nutkiewicz, Femke Lamers, Carla Nasca, Natalie Rasgon, and Brenda W.J.H. PenninxAmerican Journal of Psychiatry (online 2021)