Wu CC, Sun WH, Yang QQ, Xue L, Zhao WD. Anxiety-depression comorbidity prevalence in type 2 diabetes mellitus and correlation with insulin resistance. World J Psychiatry 2026; 16(9): 119917 [DOI: 10.5498/wjp.119917]
Corresponding Author of This Article
Wen-Di Zhao, MM, Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Bengbu Medical University, No. 287 Changhuai Road, Longzihu District, Bengbu 233030, Anhui Province, China. wendy1071@163.com
Research Domain of This Article
Psychology
Article-Type of This Article
research-article
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Wu CC, Sun WH, Yang QQ, Xue L, Zhao WD. Anxiety-depression comorbidity prevalence in type 2 diabetes mellitus and correlation with insulin resistance. World J Psychiatry 2026; 16(9): 119917 [DOI: 10.5498/wjp.119917]
World J Psychiatry. Sep 19, 2026; 16(9): 119917 Published online Sep 19, 2026. doi: 10.5498/wjp.119917
Anxiety-depression comorbidity prevalence in type 2 diabetes mellitus and correlation with insulin resistance
Chen-Chen Wu, Wei-Hua Sun, Qing-Qing Yang, Li Xue, Wen-Di Zhao
Chen-Chen Wu, Wei-Hua Sun, Qing-Qing Yang, Li Xue, Wen-Di Zhao, Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Bengbu Medical University, Bengbu 233030, Anhui Province, China
Author contributions: Wu CC designed the research and wrote the first manuscript; Wu CC, Sun WH, Yang QQ, Xue L, and Zhao WD contributed to conceiving the research and analyzing data; Wu CC and Zhao WD conducted the analysis and provided guidance for the research; and all authors reviewed and approved the final manuscript.
AI contribution statement: We have never used AI tools in writing and editing this article.
Institutional review board statement: This study was approved by the Ethic Committee of the First Affiliated Hospital of Bengbu Medical University.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: No additional data are available.
Corresponding author: Wen-Di Zhao, MM, Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Bengbu Medical University, No. 287 Changhuai Road, Longzihu District, Bengbu 233030, Anhui Province, China. wendy1071@163.com
Received: April 14, 2026 Revised: May 14, 2026 Accepted: June 10, 2026 Published online: September 19, 2026 Processing time: 131 Days and 22.1 Hours
Abstract
BACKGROUND
Patients with type 2 diabetes mellitus (T2DM) are prone to psychological symptoms such as anxiety, depression, or their comorbidity. Adverse mood can induce greater insulin resistance (IR), thereby negatively affecting T2DM development and prognosis.
AIM
To analyze anxiety-depression comorbidity status in T2DM and correlate it with IR.
METHODS
Using convenience sampling, this study enrolled eligible T2DM patients visiting The First Affiliated Hospital of Bengbu Medical University (January 2024 to June 2025). Demographic and clinical information were collected using a basic information questionnaire, and psychological symptoms were assessed using the Hamilton Anxiety Scale and Hamilton Depression Scale. Patients were categorized into T2DM, T2DM + anxiety, T2DM + depression, and T2DM + anxiety-depression groups according to anxiety and depression scores. Blood glucose and lipid levels, as well as islet function, were compared among groups. IR-associated factors in patients with T2DM with comorbid depression and anxiety were explored using logistic regression analysis.
RESULTS
Among the 197 patients with T2DM, 20.3% had neither anxiety nor depression, 29.4% had anxiety, 26.4% had depression, and 23.9% had both symptoms. Glycosylated hemoglobin, fasting plasma glucose, and 2-hour postprandial glucose levels differed significantly among groups (P < 0.05), with the highest levels observed in the T2DM + anxiety-depression group (P < 0.05). Additionally, patients with T2DM complicated by psychological symptoms showed significantly increased in triglyceride and low-density lipoprotein cholesterol levels and decreased total cholesterol and high-density lipoprotein cholesterol levels compared with patients without psychological symptoms (P < 0.05). The highest fasting insulin and fasting C-peptide levels were observed in the T2DM + anxiety-depression group (P < 0.05), while no significant differences in fasting C-peptide levels were found among the T2DM + anxiety, T2DM + depression, and T2DM + anxiety-depression groups (P > 0.05). Compared with the other groups, the T2DM + anxiety-depression group exhibited higher Homeostasis Model Assessment of IR and lower Homeostasis Model Assessment of insulin sensitivity levels (P < 0.05). Anxiety-depression comorbidity increased the risk of IR in patients with T2DM.
CONCLUSION
Anxiety and depression are prevalent among patients with T2DM, and some individuals develop comorbid conditions. Patients with anxiety-depression comorbidity exhibit relatively severe IR. Anxiety-depression comorbidity is an independent predictor of IR in T2DM.
Core Tip: This study highlights the substantial clinical burden of psychological symptoms in patients with type 2 diabetes mellitus, emphasizing that comorbid anxiety and depression are significantly associated with aggravated metabolic dysfunction. Those with concurrent anxiety and depression had worse glycemic control and greater lipid disturbances than individuals with either or no psychological symptoms. Notably, this comorbidity could independently predict severe insulin resistance, a condition featuring Homeostasis Model Assessment of insulin resistance elevation and Homeostasis Model Assessment of insulin sensitivity reduction. These findings suggest an amplified adverse effect of anxiety-depression comorbidity on insulin sensitivity, underscoring the urgency and necessity of metabolic-mental health integrated screening strategies to improve overall outcomes for type 2 diabetes mellitus patients.
