Reconsidering the role of depression and common psychiatric disorders as partners in the type 2 diabetes epidemic

doi:10.4239/wjd.v15.i6.1374

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World Journal of Diabetes

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World J Diabetes. Jun 15, 2024; 15(6): 1374-1380
Published online Jun 15, 2024. doi: 10.4239/wjd.v15.i6.1374

Reconsidering the role of depression and common psychiatric disorders as partners in the type 2 diabetes epidemic

Dario Pitocco, Paola Muti, Luigi Janiri, Alfredo Pontecorvi, Marta Rigoni, Giovanna Elsa Ute Muti Schuenemann, Giuseppe Marano, Linda Tartaglione, Andrea Corsello, Alessandro Rizzi, Marianna Mazza, Clelia Palanza, Angelo Emilio Claro

Angelo Emilio Claro, Alessandro Rizzi, Linda Tartaglione, Dario Pitocco, Diabetes Care Unit, Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome 00168, Italy

Angelo Emilio Claro, Marta Rigoni, Paola Muti, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan 20122, Italy

Clelia Palanza, Istituto Italiano di Antropologia, ISItA, Rome 00100, Italy

Marianna Mazza, Giuseppe Marano, Luigi Janiri, Unit of Psychiatry, Department of Neurosciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy

Andrea Corsello, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome 00168, Italy

Giovanna Elsa Ute Muti Schuenemann, Health Research Methods, Evidence and Impact Department, McMaster University, Ontario 1280, Canada

Alfredo Pontecorvi, Department of Endocrine-Metabolic and Dermo-Rheumatology, Fondazione Policlinico Universitario A Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy

Author contributions: Claro AE and Palanza C designed the study and wrote the first draft of the manuscript; Mazza M, Marano G, Rizzi A, Tartaglione L, Muti Schuenemann GEU, Corsello A, Rigoni M, Muti P, Pontecorvi A, Janiri L, and Pitocco D supervised and added important contributions to the paper; and all authors have read and agreed to the published version of the manuscript.

Conflict-of-interest statement: The authors declare that they do not have any conflicts of interest.

Corresponding author: Marianna Mazza, MD, PhD, Assistant Professor, Department of Neurosciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Università Cattolica del Sacro Cuore, 8 Largo A Gemelli, Rome 00168, Italy. mariannamazza@hotmail.com

Received: January 27, 2024
Revised: February 27, 2024
Accepted: April 18, 2024
Published online: June 15, 2024
Processing time: 135 Days and 21.6 Hours

Abstract

Common psychiatric disorders (CPDs) and depression contribute significantly to the global epidemic of type 2 diabetes (T2D). We postulated a possible pathophysiological mechanism that through Bridge-Symptoms present in depression and CPDs, promotes the establishment of emotional eating, activation of the reward system, onset of overweight and obesity and, ultimately the increased risk of developing T2D. The plausibility of the proposed pathophysiological mechanism is supported by the mechanism of action of drugs such as naltrexone-bupropion currently approved for the treatment of both obesity/overweight with T2D and as separate active pharmaceutical ingredients in drug addiction, but also from initial evidence that is emerging regarding glucagon-like peptide 1 receptor agonists that appear to be effective in the treatment of drug addiction. We hope that our hypothesis may be useful in interpreting the higher prevalence of CPDs and depression in patients with T2D compared with the general population and may help refine the integrated psychiatric-diabetic therapy approach to improve the treatment and or remission of T2D.

Keywords: Depression; Glucagon-like peptide-1 receptor agonists; Diabetes mellitus type 2; Stress psychological; Sleep wake disorders; Food addiction

Core Tip: Common psychiatric disorders (CPDs) and depression are important contributors to the epidemic of type 2 diabetes (T2D). Bridge-Symptoms of depression and CPDs, promote the onset of emotional eating, activation of the reward system and the development of overweight/obesity and T2D. The efficacy of naltrexone-bupropion in the treatment of overweight/obesity and drug addiction and the emerging evidence of the possible effectiveness of glucagon-like peptide 1 receptor agonists in drug addiction support our hypothesis. We propose insights to interpret the higher prevalence of CPDs and depression in patients with T2D compared to the general population and to improve the integrated psychiatric-diabetic therapy.