Is depression a risk factor for diabetic foot ulcers? 11-years follow-up of the Nord-Trøndelag Health Study (HUNT).


Journal Article

AIM: To prospectively examine whether depressive symptoms increase the risk of diabetes and a diabetic foot ulcer. METHODS: The Nord-Trøndelag Health Study (HUNT) is a community-based longitudinal study. The Hospital Anxiety and Depression Scale (HADS-D subscale) assessed depressive symptoms. We followed individuals with complete HADS-D data from HUNT2 (1995-97) and assessed whether they reported diabetes with or without a history of diabetic foot ulcer (DFU) in HUNT3 (2006-08) (n=36,031). Logistic regression was used to investigate the effect of depressive symptoms on subsequent development of diabetes and of DFU. RESULTS: Unadjusted odds for reporting diabetes at follow-up was higher among individuals who reported a HADS-D score≥8 at baseline (OR 1.30 95% CI, 1.07-1.57) than among those reporting a lower score. After adjusting for age, gender and BMI, this association was no longer significant. The odds of developing a DFU was almost two-fold (OR=1.95 95% CI, 1.02-3.74) for those reporting a HADS-D score of 8-10, and 3-fold (OR=3.06 95% CI, 1.24-7.54) for HADS-D scores≥11, compared to HADS-D scores<8, after adjusting for age, gender and serum glucose. CONCLUSIONS: Symptoms of depression at baseline are associated with an increased risk of a diabetic foot ulcer in a dose response manner during this 11-year follow-up.

Full Text

Duke Authors

Cited Authors

  • Iversen, MM; Tell, GS; Espehaug, B; Midthjell, K; Graue, M; Rokne, B; Berge, LI; Østbye, T

Published Date

  • January 2015

Published In

Volume / Issue

  • 29 / 1

Start / End Page

  • 20 - 25

PubMed ID

  • 25283486

Pubmed Central ID

  • 25283486

Electronic International Standard Serial Number (EISSN)

  • 1873-460X

Digital Object Identifier (DOI)

  • 10.1016/j.jdiacomp.2014.09.006


  • eng

Conference Location

  • United States