Antidepressant Treatment for People with Type 2 Diabetes may have a Beneficial Effect on Glycemic Control
by Mie Tomzak
Photo: Martin Gravgaard
DDA-funded researcher Christopher Rohde and his colleagues have found that the level of HbA1c (glycated haemoglobin) decreases in people with type 2 diabetes who has started antidepressant treatment. Christopher Rohde is also co-author on another article from 2021 exploring effects of mood stabilisers in people with bipolar disorder. This year, Christopher is going to Massachusetts General Hospital to work on a project centred on people with bipolar disorder.
Christopher Rohde is a PhD Student at Aarhus University Hospital. He received a grant from the Danish Diabetes Academy in 2020 to study the broad effect of antidepressant medicine on people with type 2 diabetes in his PhD project ‘The Impact of Comorbid Depression and Antidepressant Treatment on the Course of Type 2 Diabetes’.
A highly relevant research topic
As depression occurs quite frequently in people with diabetes, this is a highly relevant topic in research, especially since the risk of dying earlier from diabetes related complications is higher in people also suffering from depression.
Christopher Rohde is lead author of the recently published article ‘A Within-Subject Before-After Study of the Impact of Antidepressants on Hemoglobin A1c and Low-Density Lipoprotein Levels in Type 2 Diabetes’. The article is co-written by Reimar W. Thomsen and Søren D. Østergaard.
“The common hypothesis is that people with type 2 diabetes who are also suffering from depression have a harder time controlling their blood sugar and lipid levels. We therefore wanted to examine how antidepressant treatments might affect these parameters," explains Christopher Rohde.
Monitoring real-world data
Rohde and his associates used a register called LABKA, which stores all blood samples from the Mid and North Jutland Regions of Denmark. Through this and other Danish registers, they found patients with type 2 diabetes about to start antidepressant treatments. From here, it was a question of monitoring the blood sugar and lipid levels (LDL) of these patients, watching for possible changes. The design of the study, as Christopher Rohde explains, was just like the way doctors work in Denmark; they start a treatment, and then assess whether the patient improves afterwards through anamneses, examinations, blood tests etc.
“In the study, we found that the levels of HbA1c (glycated haemoglobin) were reduced after starting on antidepressants. We also saw a reduction in the levels of lipid, but this was the same for a control group not on antidepressants. We cannot explain the decrease in HbA1c, as it might be the result of several things. It could be related to a general recovery from the depression, it could be a direct effect on the blood sugar levels from the antidepressants, or something else entirely,” says Christopher Rohde.
Rohde further explains: "This study is just a start. More studies are required to know whether starting an antidepressant treatment leads to better regulation of blood sugar for people with type 2 diabetes. The study indicates that this could indeed be the case, but any further studies might focus more on why this is."
Study on mood stabilisers for people with bipolar disorder
In 2021, Christopher Rohde was also co-author on the article ‘Real-world effectiveness of mood stabilizers on self-harm and suicide attempts in patients with bipolar disorder: A 2-year mirror-image study’ along with Oskar Hougaard Jefsen, Søren D. Østergaard and Jimmi Nielsen. This was a somewhat similar study, as it explored how individuals with bipolar disorder responded to mood stabilisers.
“In that study, we found that lithium treatment seems to be connected to a reduced risk of self-harm. It is also known from earlier studies that lithium treatment is the most efficient way to prevent suicidal behaviour in people with bipolar disorder. The use of lithium, however, is unfortunately decreasing among people with bipolar disorder, as it is quite hard to manage, requiring blood test controls and the like. As such, there is a need for studies exploring, whether lithium is still the best treatment to prevent suicidal behaviour and self-harm in people with bipolar disorder, which is what this study substantiates,” explains Christopher Rohde.
Next stop: Boston
Christopher Rohde is already an accomplished and busy researcher. He was one of five recipients of the Lundbeck Foundation Talent Price 2020, a price given to talented young scientists under the age of 30. Next month, he is going to Boston to participate in a project with some of the best in their field.
“I am flying to Boston on April 1. I am going to be at Massachusetts General Hospital, Dauten Family Center for Bipolar Treatment Innovation, where I will be involved in projects revolved around people with bipolar disorder – a field in which they are experts. During my stay in Boston, I will also be attending some courses at Harvard University, one of which is a course about building causal hypothesis from observational data. This is important within my field of research, as I often use Danish registers to explore different correlations, including how medicines have different outcomes. The problem with these kinds of studies from the ‘real world’, though, is that one can never be sure why any given correlation occurs. That is why it is important to learn proper data methods, which can help to design studies from the real world so they resemble randomised clinical studies as much as possible. It would hereby be easier to assess the causal relationships in the associations found in observational studies”, explains Christopher Rohde.
READ THE ARTICLES HERE:
A Within-Subject Before-After Study of the Impact of Antidepressants on Hemoglobin A1c and Low-Density Lipoprotein Levels in Type 2 Diabetes’
Christopher Rohde, Reimar W. Thomsen, Søren D. Østergaard
Journal of Clinical Psychopharmacology 3 /4 2022 – Volume 42, Issue 2: A Within-Subject Before-After Study of the Impact of Antidep... : Journal of Clinical Psychopharmacology (lww.com)
Real-world effectiveness of mood stabilizers on self-harm and suicide attempts in patients with bipolar disorder: A 2-year mirror-image study
Oskar Hougaard Jefsen, Søren D. Østergaard, Jimmi Nielsen, Christopher Rohde
Journal of Affective Disorders Reports Volume 3, January 2021: Real-world effectiveness of mood stabilizers on self-harm and suicide attempts in patients with bipolar disorder: A 2-year mirror-image study - ScienceDirect
Christopher G. Rohde
PhD student, Aarhus University Hospital
Christopher Rohde (0000-0001-9458-506X) (orcid.org)