Association of Different Antidiabetic Medications with Depression Scores in Veterans

Introduction and Objective: There is a bi-directional association between depression and Type-2 Diabetes Mellitus (T2DM), with higher scores being associated with increased prevalence of cardiometabolic disease risk. Current T2DM meds of interest include Glucagon-like-peptide-1 receptor agonists (GLP1A +/- insulin or metformin), Sodium-glucose cotransporter-2 inhibitors (SGLT2i +/- ins or met), Metformin and/or Insulin. We wanted to study whether there are differences in depression scores (PHQ-9 scores) amongst these groups. We hypothesized that centrally acting agent such as GLP1A may have lower scores compared to other regimens. Methods: We conducted a cross-sectional single-timepoint study patient-visits from the DM Clinic at VA Med Center over 16 months. Of 318 patient visits we analyzed 159 patient visits that had a PHQ9 score of at least 5 or above to indicate mild, moderate, or severe depression as per PHQ9 scoring system. Results: Across the patient visits we had a mean age of 65.86±0.83 years old. The mean BMI was 32.46±0.56 across groups with SGLT2i (+/- ins or met) having a slightly lower BMI of 29.76±0.98. The mean A1C was 8.0±0.12 which was again similar across groups. GLP1A (+/- ins or met) (n=40) had a slightly lower mean PHQ9 score of 9.675±0.54 compared to other groups such as SGLT2i (+/- ins or met) (n=41) with an 11.51±0.81 and met and/or ins (n=78) with a 10.73±0.57 score, though there was no statistically significant PHQ-9 score difference across the groups. Conclusion: In a real-life setting of diabetes clinic with veterans, depression scores were lower in patients taking GLPA group, independent of differences in BMI or A1C metrics between the groups. Only about 50% of veterans with T2DM were prescribed either insulin or metformin indicating under-utilization of SGLT2i and GLP-1RA. Our ongoing study may provide insight into choice of appropriate T2DM medications that may help both concomitant T2DM and depression. Disclosure: S. Ubalde: None. K. Meyer: None. J. Powell: None. S. Sen: None.