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FRI648 GLP-1RA and SGLT2i Treatments May Show Improved Depression Metrics in Diabetes Treatment

Arad Jain, Layal Esper, Joseph Powell, Kristin Meyer,Sabyasachi Sen

Journal of the Endocrine Society(2023)

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摘要
Abstract Disclosure: A. Jain: None. L. Esper: None. J. Powell: None. K. Meyer: None. S. Sen: None. Background: Depression is a widespread condition that develops due to a multitude of etiologies. Type 2 Diabetes (T2DM) is associated with several comorbidities, including depression. A class of T2DM medication, Glucagon-Like-peptide-1 receptor agonists (GLP1RA), acts on the hypothalamus, pancreas, and other systems to reduce weight and control blood sugar. GLP1RAs may play a positive role in improving depression by improving satiety and acting on brain centers responsible for anxiety and depression. We hypothesized that patients on GLP1RA would have lower depression scores than those on insulin/metformin standard regimen, or on SGLT2 inhibitors ( which serves as an active comparator) due to localized effects of SGLT2i in the renal cortex. This research will add to ongoing studies in our lab that examine different classes of diabetes medication in treating patients with increased cardiovascular or renal risk, with the goal of increasing the specificity by which endocrinologists prescribe particular classes of glycemic control medications. Methods: We conducted a retrospective observational chart analysis at the Washington DC VA Medical Center and compared the PHQ-9 scores of 50 T2DM patients selected at random over 6 weeks maintaining a consistent diabetes care regimen for 6 months. We observed n=9 GLP1RA, n=7 SGLT2i, and n=31 control subject records. 3 subjects on both medications were excluded from this analysis. We noted the PHQ-9 scores of subjects on active psychotropics, but those were not excluded from the study at this time. Results: Our cohort had a mean age of 61.8±12.5 years and mean A1C of 8.04±2.13%. These factors were evenly distributed between analysis groups. Our analysis showed that T2DM subjects on GLP1RA had PHQ-9 scores of 5.00±1.51. This wasn’t significantly lower than the control cohort (6.21±1.22, p=0.53), or SGLT2i cohort (3.85±1.24, p=0.57). Conclusion: Our preliminary analysis in a real-life clinical setting shows a trend indicating subjects on neither GLP1RA nor SGLT2i have higher depression scores than those on either one. However, we plan to continue reviewing records to see if this trend or differences between classes is significant. With a larger sample size, we also plan to include correlations between depression scores and efficacy of treatment. Continuing this research, particularly in a VAMC cohort at higher risk of depression, may provide insight into clinical decision making in T2DM patients with history or high risk for depression and related disorders. Presentation: Friday, June 16, 2023
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