Staying Up Late May Contribute to Depression in Diabetes Patients

Patients with type 2 diabetes who stay up late and wake up late could be more likely to experience depression, compared with those who go to sleep and wake earlier, according to a new study presented at the 99^th annual meeting of the Endocrine Society.

“These findings are important because depression is common in patients with type 2 diabetes,” said lead investigator Sirimon Reutrakul, MD. “Also, previous studies show that untreated depression is related to worse patient outcomes, including diabetes self-care, blood glucose control and diabetes complications.”

Past research shows that in the general public, individuals who prefer to go to bed and wake up late (later chronotype) are more likely to experience depression than those with an earlier chronotype.

The study authors sought to determine if a later chronotype was associated with the risk of depression among patients with diabetes, who are already at an increased risk of developing the condition.

Due to differing chronotypes from geographic locations, the investigators examined patients with diabetes from 2 different regions: Chicago and Thailand.

Included in the United States-based cohort were 194 patients with diabetes, 70% of whom were women. Included in the Thailand-based research were 282 patients with diabetes, 67% of whom were women.

Patients in both cohorts answered questions regarding depression symptoms, sleep quality, and preferred times for activity and sleep. The Chicago patients were administered the questionnaires between February and April, while patients in Thailand completed the questionnaires year-round due to little seasonal variation, according to the study.

Among both cohorts, patients with a later chronotype were more likely to report depression symptoms than those with an earlier chronotype. Even after accounting for sleep quality, age, sex, and other factors, the results remained true, according to the study.

The authors said that their findings suggest a link between circadian rhythm and psychological function in these patients. However, they caution that these results do not point to a cause and effect phenomenon, but show a modest association.

If these findings prove true in additional studies, physicians should be aware of, and educate patients about, the potential complication of depression among those with diabetes who prefer to stay up later.

“We need further research to explore a combination of interventions that help with circadian timing, such as light therapy and melatonin,” Dr Reutrakul concluded. “Learning more about the relationship between depression and circadian functioning might help us figure out strategies to improve physical and mental health for patients with diabetes.”