Diabetes and depression: The impact of fluoxetine on glycemic control

Abstract

The coexistence of depression and diabetes has serious implications for self care and long term outcomes. Fluoxetine a SSRI antidepressant has hypoglycemic anorectic effects and potentially cause weight loss proportional to the degree of inial obesity. We studied the prevalence and severity of depression and the impact of its treatment with Fluoxetine on weight and glycemic control in poorly controlled depressed type 2 diabetics in an outpatient clinic in Mosul.

Forty eight type 2 diabetic patients with depression from a total of 180 diabetics seen from Jan - Sep/2003 were treated with Fluoxetine 20-40 mg daily for 12 weeks.

The prevalence of depression in type 2 diabetics is (32.22%). A significant difference was found between the mean weight, meam FBG at inclusion and 12 weeks post Fluoxetine, P < 0.001. HbA1c results available only for 28 patients and showed significant drop from a mean value of 8.8% to 7.9% after 12 weeks, P < 0.001.

Depression is common in diabetics and should be treated, preferably with SSRIs. A high index of suspicion is needed and should be considered among the risks that contribute to poor control. The future diabetic management guidelines should include routine screening for and treatment, of depression. Further larger studies seem worthwhile.