The effect of antidepressant medication use on HbA1c levels in type 2 diabetes

Abstract

Background: Chronic psychological symptoms such as anxiety and depression are known to negatively affect glycemic control in patients with type 2 diabetes (T2D). However, the impact of psychiatric treatment on glycemic outcomes remains underexplored. Objective: This study aimed to evaluate the effect of psychiatric treatment on HbA1c levels in T2D patients presenting with psychological symptoms. Methods: A total of 64 T2D patients with psychological complaints were retrospectively analyzed and divided into two groups based on psychiatric treatment status: 39 patients received antidepressant therapy, while 25 did not. Demographic data, comorbidities, and HbA1c levels before and after treatment or during follow-up were compared between groups. Statistical analyses were performed to assess differences in HbA1c changes. Results: There were no significant differences between groups regarding age, gender, or comorbid medical conditions (p>0.05). Patients receiving psychiatric treatment showed a significant reduction in HbA1c levels compared to those untreated (37.5% vs. 9.4% HbA1c decrease, p<0.001). Conversely, HbA1c levels increased in a higher proportion of untreated patients (28.1% vs. 15.6%). The reduction in HbA1c was more pronounced in individuals with baseline HbA1c levels above 8%. Patients treated with SSRIs, particularly sertraline and escitalopram, showed notable reductions in HbA1c levels. Conclusion: Our study suggests that antidepressant therapy in patients with depressive symptoms may contribute to reductions in HbA1c levels. This finding supports the notion that targeted treatment of depression can positively influence glycemic control. These results underscore the importance of integrating depression screening and management into T2D care strategies. Further longitudinal and large-scale studies are warranted to confirm these findings and clarify the mechanisms underlying the psychometabolic effects of antidepressants.