Depressive Symptoms during Adolescence and Young Adulthood and the Development of Type 2 Diabetes Mellitus

Shakira F. Suglia, Ryan T. Demmer, Richa Wahi, Katherine M. Keyes, Karestan C. Koenen

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Although depression symptoms have been associated with type 2 diabetes mellitus (T2DM) among adults, little is known about the association of adolescent-onset depression and development of T2DM in young adulthood and whether the association differs by sex. We examined the association between high levels of depressive symptoms in adolescence and T2DM in adulthood in the National Longitudinal Study of Adolescent to Adult Health (n = 12,657). Adolescents completed the 20-item version of Center for Epidemiologic Studies Depression Scale during wave 1 (mean age, 16 years) and the 10-item version during follow-up (mean age, 29 years). A high level of depressive symptoms was defined as a score of 16 or higher on the 20-item version or 11 or higher on the 10-item version. T2DM was identified 13 years after baseline on the basis of either a glycated hemoglobin concentration of at least 6.5% or use of hypoglycemic medication (with or without insulin). Participants who reported taking insulin alone were classified as having type 1 diabetes mellitus and excluded. In models adjusted for demographic characteristics, women were at a higher risk of developing T2DM if they experienced high levels of depressive symptoms during both adolescence and adulthood (odds ratio = 1.96, 95% confidence interval: 1.23, 3.11) than were those who did not experience a high level of symptoms at either time point. No statistically significant associations were noted among men (odds ratio = 0.46, 95% confidence interval: 0.20, 1.05).

Original languageEnglish (US)
Pages (from-to)269-276
Number of pages8
JournalAmerican journal of epidemiology
Issue number4
StatePublished - Feb 15 2016

Bibliographical note

Funding Information:
Author affiliations: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York (Shakira F. Suglia, Ryan T. Demmer, Richa Wahi, Katherine M. Keyes); and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts (Karestan C. Koenen). S.F.S was supported by grant K01HL103199. R.T.D. was supported by grants R00 DE-018739 and R21 DE-022422. K.M.K was supported by grant K01AA021511. This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill, and funded by grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 23 other federal agencies and foundations. Special acknowledgment is due Ronald R. Rindfuss and Barbara Entwisle, of the University of North Carolina, for assistance in the original design. Information on how to obtain the Add Health data files is available on the Add Health website ( No direct support was received from grant P01-HD31921 for this analysis. Conflict of interest: none declared.

Publisher Copyright:
© 2016 The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail:


  • cumulative effects
  • depression
  • diabetes
  • life course
  • mental health
  • young adults


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