{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:18:21Z","timestamp":1791159501883,"version":"4.1.0"},"reference-count":24,"publisher":"American Diabetes Association","issue":"2","license":[{"start":{"date-parts":[[2021,8,28]],"date-time":"2021-08-28T00:00:00Z","timestamp":1630108800000},"content-version":"vor","delay-in-days":4296,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2010,2,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>To prospectively examine the association of depression with risks for advanced macrovascular and microvascular complications among patients with type 2 diabetes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>A longitudinal cohort of 4,623 primary care patients with type 2 diabetes was enrolled in 2000\u20132002 and followed through 2005\u20132007. Advanced microvascular complications included blindness, end-stage renal disease, amputations, and renal failure deaths. Advanced macrovascular complications included myocardial infarction, stroke, cardiovascular procedures, and deaths. Medical record review, ICD-9 diagnostic and procedural codes, and death certificate data were used to ascertain outcomes in the 5-year follow-up. Proportional hazard models analyzed the association between baseline depression and risks of adverse outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>After adjustment for prior complications and demographic, clinical, and diabetes self-care variables, major depression was associated with significantly higher risks of adverse microvascular outcomes (hazard ratio 1.36 [95% CI 1.05\u20131.75]) and adverse macrovascular outcomes (1.24 [1.0\u20131.54]).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Among people with type 2 diabetes, major depression is associated with an increased risk of clinically significant microvascular and macrovascular complications over the ensuing 5 years, even after adjusting for diabetes severity and self-care activities. Clinical and public health significance of these findings rises as the incidence of type 2 diabetes soars. Further research is needed to clarify the underlying mechanisms for this association and to test interventions to reduce the risk of diabetes complications among patients with comorbid depression.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc09-1068","type":"journal-article","created":{"date-parts":[[2009,11,24]],"date-time":"2009-11-24T04:37:29Z","timestamp":1259037449000},"page":"264-269","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":426,"title":["Depression and Advanced Complications of Diabetes"],"prefix":"10.2337","volume":"33","author":[{"given":"Elizabeth H.B.","family":"Lin","sequence":"first","affiliation":[{"name":"Group Health Research Institute, Group Health, Seattle, Washington;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn M.","family":"Rutter","sequence":"additional","affiliation":[{"name":"Group Health Research Institute, Group Health, Seattle, 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