MON-661 - Analysis of Depression Scores Across Different Diabetes Medication Regimens in an Elderly Population.

Introduction and Objective
Depression is significantly more prevalent in individuals with diabetes mellitus (DM) and there is both evidence that poor DM management predicts worsening depression symptoms along with evidence that depression increases risk for DM.1,2 As such, it is important to better understand how common DM regimens such as glucagon-like peptide 1 receptor analogs (GLP-1A +/- insulin or metformin), sodium-glucose transport protein-2 inhibitors (SGLT2i +/- ins or met), Metformin (+/- ins), and insulin(ins) alone may affect depression symptoms. Our goal is to examine the differences between each group’s depression score using PHQ-9.
Methods
To determine patient depression scores at the Veterans Affairs Hospital diabetes clinic, we conducted a cross-sectional single-time point chart review of their most recent PHQ-9 scores with ranges between 0 to 26. A total of 246 all comer’s recent patient visits were screened and included for a period of 33 months. We have also investigated 126 patient subgroup whose score reflected presence of at least mild depressive symptoms (PHQ9 score at or above 5). The data was analyzed using a between subjects Kruskal-Wallis ANOVA test with follow-up tests using Mann-Whitney t-tests.
Results
All patient’s mean age was 66.15±0.70 with mean BMI of 31.45±0.40 and mean A1C of 7.8±0.09 across groups.
GLP-1A +/- ins or met group had a mean PHQ-9 score of 6.7±0.71, SGLT2i +/- ins or met group had 7.0±0.82, Metformin +/- ins group had 6.5±0.90, and Ins alone had 5.8±0.69 with no noted significant difference across groups.
In the greater than or equal to 5 of PHQ-9 score cohort, GLP-1A +/- ins or met group had a mean PHQ-9 score of 10.52±0.90 (n=33), SGLT2i +/- ins or met group had 11.91±0.94 (n=33), Metformin +/- ins group had 11.61±1.1 (n=28), and Ins alone had 10.22±0.86 (n=32) with no noted significant difference across groups.
Conclusion
The current study was planned so that we can better understand ways in which common diabetes regimens may influence depression scores and symptoms in an elderly population. Results indicate similar depression scores (with no statistical difference) across patients whose diabetes were treated with GLP-1RA, SGLT2i, insulin, or metformin, however if we consider population who had PHQ-9 score at or above 5, it appears GLP1A group and insulin alone group appear to have less scores compared to the other two groups . Future research is warranted to further clarify the relationships between elements of diabetes management and depression scores and symptoms.

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