Diabetic complications and risk of depression and anxiety among adults with type 2 diabetes

Trine Allerslev Horsbøl*, Sofie Have Hoffmann, Anne Bonde Thorsted, Siri Rosenkilde, Sara Fokdal Lehn, Allan Kofoed-Enevoldsen, Monica Santos, Peter Bindslev Iversen, Lau Caspar Thygesen

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review


AIMS: To investigate if diabetic complications increase the risk of depression and/or anxiety among adults with type 2 diabetes.

METHODS: This register-based, prospective study included 265,799 adult individuals diagnosed with type 2 diabetes between 1997 and 2017 without a recent history of depression or anxiety. Diabetic complications included cardiovascular disease, amputation of lower extremities, neuropathy, nephropathy and retinopathy. Both diabetic complications and depression and anxiety were defined by hospital contacts and prescription-based medication. All individuals were followed from the date of type 2 diabetes diagnosis until the date of incident depression or anxiety, emigration, death or 31 December 2018, whichever occurred first.

RESULTS: The total risk time was 1,915,390 person-years. The incidence rate of depression and/or anxiety was 3368 per 100,000 person-years among individuals with diabetic complications and 1929 per 100,000 person-years among those without. Having or developing any diabetic complication was associated with an increased risk of depression and/or anxiety (HR 1.77, 95% CI 1.73-1.80). The risk for depression and/or anxiety was increased for all types of diabetic complications. The strongest association was found for amputation of lower extremities (HR 2.16, 95% CI 2.01-2.31) and the weakest for retinopathy (HR 1.13, 95% CI 1.09-1.17).

CONCLUSION: Individuals with type 2 diabetes and diabetic complications are at increased risk of depression and anxiety. This points towards the importance of an increased clinical focus on mental well-being among individuals with type 2 diabetes and complications.

Original languageEnglish
Article numbere15272
JournalDiabetic Medicine
Issue number4
Publication statusPublished - Apr 2024

Bibliographical note

© 2023 Diabetes UK.


  • anxiety
  • depression
  • diabetes mellitus
  • diabetic complications
  • epidemiology
  • type 2
  • Retinal Diseases
  • Anxiety/epidemiology
  • Prospective Studies
  • Diabetes Complications/epidemiology
  • Humans
  • Diabetes Mellitus, Type 2/complications
  • Depression/epidemiology
  • Adult


Dive into the research topics of 'Diabetic complications and risk of depression and anxiety among adults with type 2 diabetes'. Together they form a unique fingerprint.

Cite this