Hyperglycemia, Type 2 Diabetes, and Depressive Symptoms

The British Whitehall II study

  1. Mika Kivimaki, PHD1,2,
  2. Adam G. Tabak, MD, PHD1,3,
  3. G. David Batty, PHD4,5,6,
  4. Archana Singh-Manoux, PHD1,7,
  5. Markus Jokela, PHD1,
  6. Tasnime N. Akbaraly, PHD1,8,
  7. Daniel R. Witte, MD, PHD9,
  8. Eric J. Brunner, PHD1,
  9. Michael G. Marmot, PHD1 and
  10. Debbie A. Lawlor, MD, PHD10
  1. 1Department of Epidemiology and Public Health, University College London, London, U.K.;
  2. 2Finnish Institute of Occupational Health, Helsinki, Finland;
  3. 31st Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Hungary;
  4. 4Medical Research Council Social and Public Health Sciences Unit, University of Glasgow, Glasgow, U.K.;
  5. 5Department of Psychology, Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, U.K.;
  6. 6Renal and Metabolic Division, The George Institute for International Health, Sydney, Australia;
  7. 7INSERM U687-IFR69, Assistance Publique-Hopitaux de Paris, Paris, France;
  8. 8INSERM U 888, Montpellier F-34093, Montpellier, France;
  9. 9Steno Diabetes Center, Gentofte, Denmark;
  10. 10Medical Research Council, Centre for Causal Analyses in Translational Epidemiology, University of Bristol, Bristol, U.K.
  1. Corresponding author: Mika Kivimaki, m.kivimaki{at}ucl.ac.uk.


OBJECTIVE To examine the recent suggestion that impaired fasting glucose may protect against depression, whereas a diagnosis of diabetes might then result in depression.

RESEARCH DESIGN AND METHODS Cross-sectional analysis of 4,228 adults (mean age 60.7 years, 73.0% men) who underwent oral glucose tolerance testing and completed the Center for Epidemiologic Studies Depression scale (CES-D).

RESULTS After adjustment for demographic factors, health behaviors, and clinical measurements (BMI, waist circumference, lipid profile, and blood pressure), there was a U-shaped association between fasting glucose and depression (Pcurve = 0.001), with elevated CES-D at low and very high glucose levels. This finding was replicable with 2-h postload glucose (P = 0.11) and A1C (P = 0.007).

CONCLUSIONS The U-shaped association between blood glucose and CES-D, with the lowest depression risk seen among those in the normoglycemic range of A1C, did not support the hypothesized protective effect of hyperglycemia.


  • The funding bodies have not influenced the conduct of this study or any of its conclusions. The views expressed here are those of authors and not necessarily those of any funding body.

  • The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

    • Received April 15, 2009.
    • Accepted July 6, 2009.
| Table of Contents

This Article

  1. Diabetes Care vol. 32 no. 10 1867-1869
  1. Online-Only Appendix
  2. All Versions of this Article:
    1. dc09-0716v1
    2. 32/10/1867 most recent