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Bidirectional association between elevated depressive symptoms and type 2 diabetes

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Do symptoms of depression predict type 2 diabetes and are people with type 2 diabetes more likely to develop depression?


10 048 people aged 45–84 years participating in the Multi-Ethnic Study of Atherosclerosis. Participants were separated into people without type 2 diabetes at baseline (n = 5201) and those without depressive symptoms at baseline (n = 4,847). Exclusions: clinical cardiovascular disease, or missing data on diabetes status, depressive symptoms or covariates of interest at baseline or follow-up.


Six communities from Maryland, Illinois, North Carolina, California, New York and Minnesota, USA; recruitment July 2000–August 2002.

Risk factors:

Risk factors of interest were type 2 diabetes in people without elevated depressive symptoms at baseline, and elevated depressive symptoms in those without type 2 diabetes at baseline. (See online notes for assessment of risk factors.)


Development of type 2 diabetes or elevated depressive symptoms.



Prospective cohort study.

Follow-up period:

Group without type 2 diabetes at baseline: 3.2 years; group without elevated depressive symptoms at baseline: 3.1 years.


At follow-up, 215 people …

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  • Source of funding: National Heart, Lung and Blood Institute, and National Institute of Diabetes, Digestive and Kidney Diseases, USA.


  • Competing interests: None.

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