OBJECTIVE To determine bidirectional associations between the timing of chronic diabetes complications (CDCs) and mental health disorders (MHDs) in individuals with type 1 or type 2 diabetes. RESEARCH DESIGN AND METHODS We used a nationally representative health care claims database to identify matched individuals with type 1 or 2 diabetes or without diabetes using a propensity score quasirandomization technique stratified by age (0–19, 20–39, 40–59, and 60+ years). CDCs and MHDs were identified using ICD-9/10 codes. We fit Cox proportional hazards models with time-varying diagnoses of CDCs or MHDs to investigate their association with the hazard of developing MHDs or CDCs, respectively. RESULTS From 2001 to 2018, a total of 553,552 individuals were included (44,735 with type 1 diabetes, 152,187 with type 2 diabetes, and 356,630 without diabetes). We found that having a CDC increased the hazard of developing an MHD (hazard ratio [HR] 1.9–2.9; P < 0.05, with higher HRs in older age strata), and having an MHD increased the hazard of developing a CDC (HR 1.4–2.5; P < 0.05, with the highest HR in age stratum 0–19 years). In those age <60 years, individuals with type 1 diabetes were more likely to have CDCs, whereas individuals with type 2 diabetes were more likely to have MHDs. However, the relationship between CDCs and MHDs in either direction was not affected by diabetes type (P > 0.05 for interaction effects). CONCLUSIONS We found a consistent bidirectional association between CDCs and MHDs across the life span, highlighting the important relationship between CDCs and MHDs. Prevention and treatment of either comorbidity may help reduce the risk of developing the other.

中文翻译：

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1 型或 2 型糖尿病患者的心理健康障碍与慢性糖尿病并发症之间的双向关联


目的 确定 1 型或 2 型糖尿病患者慢性糖尿病并发症 (CDC) 与精神健康障碍 (MHD) 发生时间之间的双向关联。研究设计和方法 我们使用具有全国代表性的医疗保健索赔数据库，使用按年龄（0-19、20-39、40-59 和 60）分层的倾向评分准随机化技术来识别患有 1 型或 2 型糖尿病或未患糖尿病的匹配个体。 + 年）。 CDC 和 MHD 使用 ICD-9/10 代码进行识别。我们将 Cox 比例风险模型与 CDC 或 MHD 的时变诊断进行拟合，以分别研究它们与发展 MHD 或 CDC 的风险之间的关联。结果从2001年到2018年，总共纳入了553,552人（44,735人患有1型糖尿病，152,187人患有2型糖尿病，356,630人没有糖尿病）。我们发现患有 CDC 会增加患 MHD 的风险（风险比 [HR] 1.9–2.9；P < 0.05，老年群体的 HR 较高），并且患有 MHD 会增加患 CDC 的风险（HR） 1.4–2.5；P < 0.05，HR 在 0–19 岁年龄段最高）。在 <60 岁的人群中，1 型糖尿病患者更有可能患有 CDC，而 2 型糖尿病患者更有可能患有 MHD。然而，CDC 和 MHD 之间任一方向的关系均不受糖尿病类型的影响（交互作用 P > 0.05）。结论 我们发现在整个生命周期中 CDC 和 MHD 之间存在一致的双向关联，这凸显了 CDC 和 MHD 之间的重要关系。预防和治疗其中一种合并症可能有助于降低患另一种合并症的风险。