{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T21:18:38Z","timestamp":1791839918153,"version":"4.3.4"},"reference-count":60,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2019,7,31]],"date-time":"2019-07-31T00:00:00Z","timestamp":1564531200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet. Med."],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    To conduct a systematic review and meta\u2010analysis of longitudinal studies assessing the bi\u2010directional association between depression and diabetes macrovascular and microvascular complications. Embase, Medline and Psyc\n                    <jats:styled-content style=\"fixed-case\">INFO<\/jats:styled-content>\n                    databases were searched from inception through 27 November 2017. A total of 4592 abstracts were screened for eligibility. Meta\u2010analyses used multilevel random\/mixed\u2010effects models. Quality was assessed using the Newcastle\u2010Ottawa scale. Twenty\u2010two studies were included in the systematic review. Sixteen studies examined the relationship between baseline depression and incident diabetes complications, of which nine studies involving over one million participants were suitable for meta\u2010analysis. Depression was associated with an increased risk of incident macrovascular (\n                    <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                    = 1.38; 95%\n                    <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                    : 1.30\u20131.47) and microvascular disease (\n                    <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                    = 1.33; 95%\n                    <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                    : 1.25\u20131.41). Six studies examined the association between baseline diabetes complications and subsequent depression, of which two studies involving over 230 000 participants were suitable for meta\u2010analysis. The results showed that diabetes complications increased the risk of incident depressive disorder (\n                    <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                    = 1.14; 95%\n                    <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                    : 1.07\u20131.21). The quality analysis showed increased risk of bias notably in the representativeness of selected cohorts and ascertainment of exposure and outcome. Depression in people with diabetes is associated with an increased risk of incident macrovascular and microvascular complications. The relationship between depression and diabetes complications appears bi\u2010directional. However, the risk of developing diabetes complications in depressed people is higher than the risk of developing depression in people with diabetes complications. The underlying mechanisms warrant further research.\n                  <\/jats:p>","DOI":"10.1111\/dme.14054","type":"journal-article","created":{"date-parts":[[2019,6,19]],"date-time":"2019-06-19T05:51:21Z","timestamp":1560923481000},"page":"1562-1572","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":271,"title":["Longitudinal associations between depression and diabetes complications: a systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0609-4082","authenticated-orcid":false,"given":"A.","family":"Nouwen","sequence":"first","affiliation":[{"name":"Middlesex University London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5085-6662","authenticated-orcid":false,"given":"M. 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