688-P: Severity of Type 2 Diabetes and the Risk of Depression—A Nationwide Population-Based Study

Background: Because of a bidirectional relationship between type 2 diabetes mellitus (T2DM) and depression, we aimed to investigate the association of the severity of diabetes with the risk of depression. Methods: Total 2,067,017 adults who diagnosis with T2DM excluding those diagnosed with depression before were identified from a nationwide population-based cohort in Korea. Diabetes mellitus (DM) severity scores consisted of insulin user, DM duration more than 5 years, using 3 or more oral hypoglycemic agents, and diagnosed with DM complications including chronic kidney disease, myocardial infarction, stroke, and diabetes retinopathy. DM severity scores were calculated as 0 to 6. Results: As the DM severity score was increased, the frequency of depression was significantly increased, and the follow up period until the diagnosed with depression was significantly decreased. This tendency of increasing depression incidence was also significant in each components constituting the DM severity score. Conclusion: An increase in the severity of diabetes, represented by duration of diabetes, insulin or multi-drug use, and presence of major complications of diabetes, was associated with higher risk of depression. Physicians should carefully monitor whether depression develops in patients with uncontrolled diabetes in order to improve quality of life and achieve glycemic control goals.