nach oben

Current Diabetes Reports

Erschienen in:

01.06.2014 | Diabetes and Other Diseases-Emerging Associations (JJ Nolan, Section Editor)

Diabetes and Depression

verfasst von: Richard I. G. Holt, Mary de Groot, Sherita Hill Golden

Erschienen in: Current Diabetes Reports | Ausgabe 6/2014

Einloggen, um Zugang zu erhalten

Abstract

Diabetes and depression occur together approximately twice as frequently as would be predicted by chance alone. Comorbid diabetes and depression are a major clinical challenge as the outcomes of both conditions are worsened by the other. Although the psychological burden of diabetes may contribute to depression, this explanation does not fully explain the relationship between these 2 conditions. Both conditions may be driven by shared underlying biological and behavioral mechanisms, such as hypothalamic-pituitary-adrenal axis activation, inflammation, sleep disturbance, inactive lifestyle, poor dietary habits, and environmental and cultural risk factors. Depression is frequently missed in people with diabetes despite effective screening tools being available. Both psychological interventions and antidepressants are effective in treating depressive symptoms in people with diabetes but have mixed effects on glycemic control. Clear care pathways involving a multidisciplinary team are needed to obtain optimal medical and psychiatric outcomes for people with comorbid diabetes and depression.

Whiting DR, Guariguata L, Weil C, Shaw J. IDF Diabetes Atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Res Clin Pract. 2011;94:311–21.PubMedCrossRef

Cross-national comparisons of the prevalences and correlates of mental disorders. WHO International Consortium in Psychiatric Epidemiology Bull World Health Organ. 2000;78:413–26.

Anderson RJ, Freedland KE, Clouse RE, Lustman PJ. The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care. 2001;24:1069–78.PubMedCrossRef

Holt RI, Katon WJ. Dialogue on diabetes and depression: dealing with the double burden of comorbidity. J Affect Disord. 2012;142(Suppl):S1–3.PubMedCrossRef

Egede LE, Zheng D, Simpson K. Comorbid depression is associated with increased health care use and expenditures in individuals with diabetes. Diabetes Care. 2002;25:464–70.PubMedCrossRef

Holt RI. Undoing Descartes: integrating diabetes care for those with mental illness. Pract Diabetes. 2011;28:270–5.CrossRef

Willis T. Pharmaceutice rationalis sive diabtriba de medicamentorum operantionibus in humano corpore. Oxford; 1675.

Sartorius N, Cimino L. The Dialogue on Diabetes and Depression (DDD): origins and achievements. J Affect Disord. 2012;142(Suppl):S4–7.PubMedCrossRef

International Conference on Diabetes and Depression. Available at: http://www.niddk.nih.gov/news/events-calendar/Pages/international-conference-on-diabetes-and-depression.aspx.

10.

Fisher L, Glasgow RE, Strycker LA. The relationship between diabetes distress and clinical depression with glycemic control among patients with type 2 diabetes. Diabetes Care. 2010;33:1034–6.PubMedCentralPubMedCrossRef

11.

Fisher L, Mullan JT, Arean P, Glasgow RE, Hessler D, Masharani U. Diabetes distress but not clinical depression or depressive symptoms is associated with glycemic control in both cross-sectional and longitudinal analyses. Diabetes Care. 2010;33:23–8.PubMedCentralPubMedCrossRef

12.

Nouwen A, Winkley K, Twisk J, Lloyd CE, Peyrot M, Ismail K, et al. Type 2 diabetes mellitus as a risk factor for the onset of depression: a systematic review and meta-analysis. Diabetologia. 2010;53:2480–6.PubMedCentralPubMedCrossRef

13.

Peyrot M, Rubin RR. Persistence of depressive symptoms in diabetic adults. Diabetes Care. 1999;22:448–52.PubMedCrossRef

14.

Lustman PJ, Griffith LS, Clouse RE. Depression in adults with diabetes. Results of 5-yr follow-up study. Diabetes Care. 1988;11:605–12.PubMedCrossRef

15.

Reynolds KA, Helgeson VS. Children with diabetes compared with peers: Depressed? Distressed? A meta-analytic review. Ann Behav Med. 2011;42:29–41.PubMedCentralPubMedCrossRef

16.

Mezuk B, Eaton WW, Albrecht S, Golden SH. Depression and type 2 diabetes over the lifespan: a meta-analysis. Diabetes Care. 2008;31:2383–90.PubMedCentralPubMedCrossRef

17.

Golden SH, Lazo M, Carnethon M, Bertoni AG, Schreiner PJ, Diez Roux AV, et al. Examining a bidirectional association between depressive symptoms and diabetes. JAMA. 2008;299:2751–9.PubMedCentralPubMedCrossRef

18.

Knol MJ, Twisk JW, Beekman AT, Heine RJ, Snoek FJ, Pouwer F. Depression as a risk factor for the onset of type 2 diabetes mellitus. A meta-analysis. Diabetologia. 2006;49:837–45.PubMedCrossRef

19.

Hermanns N, Kulzer B, Krichbaum M, Kubiak T, Haak T. Affective and anxiety disorders in a German sample of diabetic patients: prevalence, comorbidity and risk factors. Diabetes Med. 2005;22:293–300.CrossRef

20.

Li C, Ford ES, Strine TW, Mokdad AH. Prevalence of depression among U.S. adults with diabetes: findings from the 2006 behavioral risk factor surveillance system. Diabetes Care. 2008;31:105–7.PubMedCrossRef

21.

de Groot M, Anderson R, Freedland KE, Clouse RE, Lustman PJ. Association of depression and diabetes complications: a meta-analysis. Psychosom Med. 2001;63:619–30.PubMedCrossRef

22.

van Steenbergen-Weijenburg KM, van Puffelen AL, Horn EK, Nuyen J, van Dam PS, van Benthem TB, et al. More co-morbid depression in patients with Type 2 diabetes with multiple complications. An observational study at a specialized outpatient clinic. Diabetes Med. 2011;28:86–9.CrossRef

23.••

Nouwen A, Nefs G, Caramlau I, Connock M, Winkley K, Lloyd CE, et al. Prevalence of depression in individuals with impaired glucose metabolism or undiagnosed diabetes: a systematic review and meta-analysis of the European Depression in Diabetes (EDID) Research Consortium. Diabetes Care. 2011;34:752–62. This meta-analysis compares the prevalence of depression in people with known and undiagnosed diabetes and impaired glucose tolerance. The higher rates in those with diagnosed diabetes suggest that the knowledge of the diagnosis and the burden of managing the condition and its complications are associated with depressive symptoms rather than biological mechanisms such as hyperglycemia.PubMedCentralPubMedCrossRef

24.

McMartin SE, Jacka FN, Colman I. The association between fruit and vegetable consumption and mental health disorders: evidence from five waves of a national survey of Canadians. Prev Med. 2013;56:225–30.PubMedCrossRef

25.

Payne ME, Steck SE, George RR, Steffens DC. Fruit, vegetable, and antioxidant intakes are lower in older adults with depression. J Acad Nutr Diet. 2012;112:2022–7.PubMedCentralPubMedCrossRef

26.

Weyerer S. Physical inactivity and depression in the community. Evidence from the Upper Bavarian Field Study. Int J Sports Med. 1992;13:492–6.PubMedCrossRef

27.

Gonzalez JS, Peyrot M, McCarl LA, Collins EM, Serpa L, Mimiaga MJ, et al. Depression and diabetes treatment nonadherence: a meta-analysis. Diabetes Care. 2008;31:2398–403.PubMedCentralPubMedCrossRef

28.

Gonzalez JS, Safren SA, Cagliero E, Wexler DJ, Delahanty L, Wittenberg E, et al. Depression, self-care, and medication adherence in type 2 diabetes: relationships across the full range of symptom severity. Diabetes Care. 2007;30:2222–7.PubMedCrossRef

29.•

Barnard K, Peveler RC, Holt RI. Antidepressant medication as a risk factor for type 2 diabetes and impaired glucose regulation: systematic review. Diabetes Care. 2013;36:3337–45. This systematic review examines the evidence for a causal relationship between antidepressants and diabetes.PubMedCentralPubMedCrossRef

30.

Lyoo IK, Yoon SJ, Musen G, Simonson DC, Weinger K, Bolo N, et al. Altered prefrontal glutamate-glutamine-gamma-aminobutyric acid levels and relation to low cognitive performance and depressive symptoms in type 1 diabetes mellitus. Arch Gen Psychiatry. 2009;66:878–87.PubMedCrossRef

31.

Ho N, Sommers MS, Lucki I. Effects of diabetes on hippocampal neurogenesis: links to cognition and depression. Neurosci Biobehav Rev. 2013;37:1346–62.PubMedCentralPubMedCrossRef

32.

Champaneri S, Wand GS, Malhotra SS, Casagrande SS, Golden SH. Biological basis of depression in adults with diabetes. Curr Diab Rep. 2010;10:396–405.PubMedCrossRef

33.

Courtet P, Olie E. Circadian dimension and severity of depression. Eur Neuropsychopharmacol. 2012;22 Suppl 3:S476–81.PubMedCrossRef

34.

Gangwisch JE. Epidemiological evidence for the links between sleep, circadian rhythms and metabolism. Obes Rev. 2009;10 Suppl 2:37–45.PubMedCentralPubMedCrossRef

35.

Kan C, Silva N, Golden SH, Rajala U, Timonen M, Stahl D, et al. A systematic review and meta-analysis of the association between depression and insulin resistance. Diabetes Care. 2013;36:480–9.PubMedCentralPubMedCrossRef

36.

Musselman DL, Betan E, Larsen H, Phillips LS. Relationship of depression to diabetes types 1 and 2: epidemiology, biology, and treatment. Biol Psychiatry. 2003;54:317–29.PubMedCrossRef

37.

Dantzer R, O’Connor JC, Freund GG, Johnson RW, Kelley KW. From inflammation to sickness and depression: when the immune system subjugates the brain. Nat Rev Neurosci. 2008;9:46–56.PubMedCentralPubMedCrossRef

38.

Berends LM, Ozanne SE. Early determinants of type-2 diabetes. Best Pract Res Clin Endocrinol Metab. 2012;26:569–80.PubMedCrossRef

39.

Thompson C, Syddall H, Rodin I, Osmond C, Barker DJ. Birth weight and the risk of depressive disorder in late life. Br J Psychiatry. 2001;179:450–5.PubMedCrossRef

40.

Kajantie E, Raikkonen K. Early life predictors of the physiological stress response later in life. Neurosci Biobehav Rev. 2010;35:23–32.PubMedCrossRef

41.

Colman I, Ataullahjan A, Naicker K, Van Lieshout RJ. Birth weight, stress, and symptoms of depression in adolescence: evidence of fetal programming in a national Canadian cohort. Can J Psychiatry. 2012;57:422–8.PubMed

42.

Vasiliadis HM, Gilman SE, Buka SL. Fetal growth restriction and the development of major depression. Acta Psychiatr Scand. 2008;117:306–12.PubMedCrossRef

43.

Phillips DI. Programming of the stress response: a fundamental mechanism underlying the long-term effects of the fetal environment? J Intern Med. 2007;261:453–60.PubMedCrossRef

44.

de Vet E, de Ridder DT, de Wit JB. Environmental correlates of physical activity and dietary behaviours among young people: a systematic review of reviews. Obes Rev. 2011;12:e130–42.PubMedCrossRef

45.

Skinner ML, Shirtcliff EA, Haggerty KP, Coe CL, Catalano RF. Allostasis model facilitates understanding race differences in the diurnal cortisol rhythm. Dev Psychopathol. 2011;23:1167–86.PubMedCentralPubMedCrossRef

46.

Brenner AB, Zimmerman MA, Bauermeister JA, Caldwell CH. The physiological expression of living in disadvantaged neighborhoods for youth. J Youth Adolesc. 2013;42:792–806.PubMedCentralPubMedCrossRef

47.

Karb RA, Elliott MR, Dowd JB, Morenoff JD. Neighborhood-level stressors, social support, and diurnal patterns of cortisol: the Chicago Community Adult Health Study. Soc Sci Med. 2012;75:1038–47.PubMedCentralPubMedCrossRef

48.

Do DP, Diez Roux AV, Hajat A, Auchincloss AH, Merkin SS, Ranjit N, et al. Circadian rhythm of cortisol and neighborhood characteristics in a population-based sample: the Multi-Ethnic Study of Atherosclerosis. Health Place. 2011;17:625–32.PubMedCentralPubMedCrossRef

49.

Dulin-Keita A, Casazza K, Fernandez JR, Goran MI, Gower B. Do neighbourhoods matter? Neighbourhood disorder and long-term trends in serum cortisol levels. J Epidemiol Community Health. 2012;66:24–9.PubMedCentralPubMedCrossRef

50.

Browning CR, Cagney KA, Iveniuk J. Neighborhood stressors and cardiovascular health: crime and C-reactive protein in Dallas, USA. Soc Sci Med. 2012;75:1271–9.PubMedCrossRef

51.

Broyles ST, Staiano AE, Drazba KT, Gupta AK, Sothern M, Katzmarzyk PT. Elevated C-reactive protein in children from risky neighborhoods: evidence for a stress pathway linking neighborhoods and inflammation in children. PLoS One. 2012;7:e45419.PubMedCentralPubMedCrossRef

52.

Goldney RD, Phillips PJ, Fisher LJ, Wilson DH. Diabetes, depression, and quality of life: a population study. Diabetes Care. 2004;27:1066–70.PubMedCrossRef

53.

Jacobson AM, de Groot M, Samson JA. The effects of psychiatric disorders and symptoms on quality of life in patients with type I and type II diabetes mellitus. Qual Life Res. 1997;6:11–20.PubMedCrossRef

54.

Carper MM, Traeger L, Gonzalez JS, Wexler DJ, Psaros C, Safren SA. The differential associations of depression and diabetes distress with quality of life domains in type 2 diabetes. J Behav Med. 2013. [Epub ahead of print].

55.

Ludman EJ, Katon W, Russo J, Von Korff M, Simon G, Ciechanowski, et al. Depression and diabetes symptom burden. Gen Hosp Psychiatry. 2004;26:430–6.PubMedCrossRef

56.

Lustman PJ, Anderson RJ, Freedland KE, de Groot M, Carney RM, Clouse RE. Depression and poor glycemic control: a meta-analytic review of the literature. Diabetes Care. 2000;23:934–42.PubMedCrossRef

57.

Hislop AL, Fegan PG, Schlaeppi MJ, Duck M, Yeap BB. Prevalence and associations of psychological distress in young adults with Type 1 diabetes. Diabetes Med. 2008;25:91–6.CrossRef

58.

Aikens JE, Perkins DW, Piette JD, Lipton B. Association between depression and concurrent Type 2 diabetes outcomes varies by diabetes regimen. Diabetes Med. 2008;25:1324–9.

59.•

Park M, Katon WJ, Wolf FM. Depression and risk of mortality in individuals with diabetes: a meta-analysis and systematic review. Gen Hosp Psychiatry. 2013;35:217–25. This meta-analysis shows that depression, even if mild, is also associated with premature mortality through a range of physical conditions.PubMedCentralPubMedCrossRef

60.

O’Connor PJ, Narayan KM, Anderson R, Feeney P, Fine L, Ali MK, et al. Effect of intensive vs standard blood pressure control on depression and health-related quality of life in type 2 diabetes: the ACCORD trial. Diabetes Care. 2012;35:1479–81.PubMedCentralPubMedCrossRef

61.

Robins LN, Wing J, Wittchen HU, Helzer JE, Babor TF, Burk. The Composite International Diagnostic Interview. An epidemiologic instrument suitable for use in conjunction with different diagnostic systems and in different cultures. Arch Gen Psychiatry. 1988;45:1069–77.PubMedCrossRef

62.

Amorim P, Lecrubier Y, Weiller E, Hergueta T, Sheehan D. DSM-IH-R Psychotic disorders: procedural validity of the Mini International Neuropsychiatric Interview (MINI). Concordance and causes for discordance with the CIDI. Eur Psychiatry. 1998;13:26–34.PubMedCrossRef

63.

Holt RI, van der Feltz-Cornelis CM. Key concepts in screening for depression in people with diabetes. J Affect Disord. 2012;142(Suppl):S72–9.PubMedCrossRef

64.•

Roy T, Lloyd CE, Pouwer F, Holt RI, Sartorius N. Screening tools used for measuring depression among people with Type 1 and Type 2 diabetes: a systematic review. Diabetes Med. 2012;29:164–75. This systematic review provides evidence of the validated screening tools for assessing depression in people with diabetes.CrossRef

65.

Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561–71.PubMedCrossRef

66.

Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1:385–401.CrossRef

67.

Kroenke K, Spitzer RL, Williams JB, Lowe B. The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: a systematic review. Gen Hosp Psychiatry. 2010;32:345–59.PubMedCrossRef

68.

Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67:361–70.PubMedCrossRef

69.

van Steenbergen-Weijenburg KM, de Vroege L, Ploeger RR, Brals JW, Vloedbeld MG, Veneman TF, et al. Validation of the PHQ-9 as a screening instrument for depression in diabetes patients in specialized outpatient clinics. BMC Health Serv Res. 2010;10:235.PubMedCentralPubMedCrossRef

70.

Whooley MA, Avins AL, Miranda J, Browner WS. Case-finding instruments for depression. Two questions are as good as many. J Gen Intern Med. 1997;12:439–45.PubMedCentralPubMedCrossRef

71.•

Pouwer F, Tack CJ, Geelhoed-Duijvestijn PH, Bazelmans E, Beekman AT, Heine RJ, et al. Limited effect of screening for depression with written feedback in outpatients with diabetes mellitus: a randomized controlled trial. Diabetologia. 2011;54:741–8. This randomized trial shows that depression screening per se does not improve clinical outcomes and therefore highlights the importance of linking screening to appropriate depression care pathways.PubMedCentralPubMedCrossRef

72.

Gilbody S, Sheldon T, House A. Screening and case-finding instruments for depression: a meta-analysis. CMAJ. 2008;178:997–1003.PubMedCentralPubMedCrossRef

73.

van der Feltz-Cornelis CM, Nuyen J, Stoop C, Chan J, Jacobson AM, Katon W, et al. Effect of interventions for major depressive disorder and significant depressive symptoms in patients with diabetes mellitus: a systematic review and meta-analysis. Gen Hosp Psychiatry. 2010;32:380–95.PubMedCrossRef

74.

Lustman PJ, Griffith LS, Freedland KE, Kissel SS, Clouse RE. Cognitive behavior therapy for depression in type 2 diabetes mellitus. A randomized, controlled trial. Ann Intern Med. 1998;129:613–21.PubMedCrossRef

75.

Katon WJ, Von Korff M, Lin EH, Simon G, Ludman E, Russo J, et al. The Pathways Study: a randomized trial of collaborative care in patients with diabetes and depression. Arch Gen Psychiatry. 2004;61:1042–9.PubMedCrossRef

76.

van Bastelaar KM, Pouwer F, Cuijpers P, Riper H, Snoek FJ. Web-based depression treatment for type 1 and type 2 diabetic patients: a randomized, controlled trial. Diabetes Care. 2011;34:320–5.PubMedCentralPubMedCrossRef

77.

van der Feltz-Cornelis CM. Comorbid diabetes and depression: do E-health treatments achieve better diabetes control? Diabetes Manag. 2013;3:379–88.CrossRef

78.

Lustman PJ, Griffith LS, Clouse RE, Freedland KE, Eisen SA, Rubin EH, et al. Effects of nortriptyline on depression and glycemic control in diabetes: results of a double-blind, placebo-controlled trial. Psychosom Med. 1997;59:241–50.PubMedCrossRef

79.

Lustman PJ, Freedland KE, Griffith LS, Clouse RE. Fluoxetine for depression in diabetes: a randomized double-blind placebo-controlled trial. Diabetes Care. 2000;23:618–23.PubMedCrossRef

80.

Gulseren L, Gulseren S, Hekimsoy Z, Mete L. Comparison of fluoxetine and paroxetine in type II diabetes mellitus patients. Arch Med Res. 2005;36:159–65.PubMedCrossRef

81.

Khazaie H, Rahimi M, Tatari F, Rezaei M, Najafi F, Tahmasian M. Treatment of depression in type 2 diabetes with Fluoxetine or Citalopram? Neurosciences. 2011;16:42–5.PubMed

82.

Lustman PJ, Williams MM, Sayuk GS, Nix BD, Clouse RE. Factors influencing glycemic control in type 2 diabetes during acute- and maintenance-phase treatment of major depressive disorder with bupropion. Diabetes Care. 2007;30:459–66.PubMedCrossRef

83.

Goodnick PJ, Kumar A, Henry JH, Buki VM, Goldberg RB. Sertraline in coexisting major depression and diabetes mellitus. Psychopharmacol Bull. 1997;33:261–4.PubMed

84.

Williams MM, Clouse RE, Nix BD, Rubin EH, Sayuk GS, McGill JB, et al. Efficacy of sertraline in prevention of depression recurrence in older vs younger adults with diabetes. Diabetes Care. 2007;30:801–6.PubMedCrossRef

85.

Amsterdam JD, Shults J, Rutherford N, Schwartz S. Safety and efficacy of escitalopram in patients with comorbid major depression and diabetes mellitus. Neuropsychobiology. 2006;54:208–14.PubMedCrossRef

86.

National Collaborating Centre for Mental Health. Common mental health disorders: identification and pathways to care CG123. 2011. London, National Institute of Health and Clinical Excellence.

87.

Serretti A, Mandelli L. Antidepressants and body weight: a comprehensive review and meta-analysis. J Clin Psychiatry. 2010;71:1259–72.PubMedCrossRef

88.

Sayuk GS, Gott BM, Nix BD, Lustman PJ. Improvement in sexual functioning in patients with type 2 diabetes and depression treated with bupropion. Diabetes Care. 2011;34:332–4.PubMedCentralPubMedCrossRef

89.

Disability Rights Commission. Equal treatment: closing the gap. A formal investigation into physical health inequalities experienced by people with learning difficulties and mental health problems. London: Disability Rights Commission; 2006.

90.

Mitchell AJ, Malone D, Doebbeling CC. Quality of medical care for people with and without comorbid mental illness and substance misuse: systematic review of comparative studies. Br J Psychiatry. 2009;194:491–9.PubMedCrossRef

91.

Lawrence D, Coghlan R. Health inequalities and the health needs of people with mental illness. N S W Public Health Bull. 2002;13:155–8.PubMedCrossRef

92.

Frayne SM, Halanych JH, Miller DR, Wang F, Lin H, Pogach L, et al. Disparities in diabetes care: impact of mental illness. Arch Intern Med. 2005;165:2631–8.PubMedCrossRef

93.

Katon WJ, Lin EH, Von KM, Ciechanowski P, Ludman EJ, Young B, et al. Collaborative care for patients with depression and chronic illnesses. N Engl J Med. 2010;363:2611–20.PubMedCentralPubMedCrossRef

94.•

Molosankwe I, Patel A, Jose GJ, Knapp M, McDaid D. Economic aspects of the association between diabetes and depression: a systematic review. J Affect Disord. 2012;14(Suppl):S42–55. This review describes the economic burden of the comorbidity of diabetes and depression.CrossRef

95.

Simon GE, Katon WJ, Lin EH, Rutter C, Manning WG, Von Korff M, et al. Cost-effectiveness of systematic depression treatment among people with diabetes mellitus. Arch Gen Psychiatry. 2007;64:65–72.PubMedCrossRef

96.

Katon W, Unutzer J, Fan MY, Williams Jr JW, Schoenbaum M, Lin EH, et al. Cost-effectiveness and net benefit of enhanced treatment of depression for older adults with diabetes and depression. Diabetes Care. 2006;29:265–70.PubMedCrossRef

97.

Hay JW, Katon WJ, Ell K, Lee PJ, Guterman J. Cost effectiveness analysis of collaborative care management of major depression among low-income, predominantly Hispanics with diabetes. Value Health. 2012;15:249–54.PubMedCentralPubMedCrossRef

98.

Nicholson TR, Taylor JP, Gosden C, Trigwell P, Ismail K. National guidelines for psychological care in diabetes: how mindful have we been? Diabetes Med. 2009;26:447–50.CrossRef

Titel: Diabetes and Depression
verfasst von: Richard I. G. Holt
Mary de Groot
Sherita Hill Golden
Publikationsdatum: 01.06.2014
Verlag: Springer US
Erschienen in: Current Diabetes Reports / Ausgabe 6/2014
Print ISSN: 1534-4827
Elektronische ISSN: 1539-0829
DOI: https://doi.org/10.1007/s11892-014-0491-3

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

25.04.2024 | Hypotonie | Nachrichten

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Diabetes and Depression

Abstract

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

Viel Bewegung in der Parkinsonforschung

Adjuvante Immuntherapie verlängert Leben bei RCC

Update Innere Medizin

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 6/2014

Reassessment of Insulin Dosing Guidelines in Continuous Subcutaneous Insulin Infusion Treated Type 1 Diabetes

Counterpoint: Establishing Consensus in the Diagnosis of GDM Following the HAPO Study

Lipotoxicity in the Pancreatic Beta Cell: Not Just Survival and Function, but Proliferation as Well?

Cardiovascular Risk Stratification and Management in Pre-Diabetes

Environmental Endocrine Disruption of Energy Metabolism and Cardiovascular Risk

The Negative Effects of Obesity and Poor Glycemic Control on Cognitive Function: A Proposed Model for Possible Mechanisms

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

Viel Bewegung in der Parkinsonforschung

Adjuvante Immuntherapie verlängert Leben bei RCC

Update Innere Medizin