A new analysis suggests that tackling inflammation in diabetes could be key to improving depression treatment outcomes — but the effects differ between type 1 and type 2 diabetes, researchers report.
Type 2 diabetes is a metabolic disorder characterized by the body’s reduced ability to manage blood sugar, whereas type 1 diabetes is an autoimmune condition in which the immune system attacks insulin-producing pancreatic cells.
“People with type 2 diabetes and high inflammation levels may respond particularly well to changes in depressive thinking through cognitive behavioural therapy (CBT). In contrast, those with type 1 diabetes and high inflammation might benefit more from anti-inflammatory medications,” said Norbert Hermanns from the Research Institute of the Diabetes Academy Mergentheim (FIDAM), Germany.
Published in Diabetologia, the findings could guide personalised treatment strategies for diabetes patients, who are at roughly twice the risk of depression compared to the general population. Depression in diabetics is often linked to anxiety, feelings of illness, and reduced treatment progress.
Researchers studied 521 people with type 1 or type 2 diabetes over one year, measuring 76 inflammatory blood markers to assess links with depressive symptoms.
For type 2 diabetes patients with higher inflammation, CBT significantly improved depressive symptoms such as joylessness. However, in type 1 diabetes patients with high inflammation, CBT showed smaller gains, especially for fatigue, sleep problems, and appetite loss.
The team suggests that the differences may stem from distinct immune mechanisms — autoimmune processes in type 1 diabetes versus metabolic inflammation in type 2 diabetes. In type 2 diabetes, 26 biomarkers were tied to better depression outcomes, while in type 1 diabetes, 13 biomarkers were linked to smaller improvements.