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[Abstract] Objective To investigate the clinical effect of escitalopram combined with insulin in the treatment of type 2 diabetes (T2DM) patients with depression and its influence on depressive symptoms and blood glucose levels. Methods A total of 96 T2DM patients with depression in our hospital (from August 2018-May 2020) were selected and divided into study group (n=48) and control group (n=48) by random number table. All were given psychological intervention, the control group was treated with insulin, and the study group was treated with escitalopram on the above basis. The clinical efficacy, blood glucose levels [fasting blood glucose (FBG), 2h postprandial blood glucose (2hPG), glycosylated hemoglobin (HbA1c)], depression (HAMD) score and the levels of hormones on the hypothalamus-pituitary-adrenal (HPA) axis [(plasma cortisol (Cor), adrenocorticotropic hormone (ACTH), homocysteine (Hcy)] before treatment and 12 weeks after treatment, the incidence of adverse reactions of the two groups were statistically compared. Results The total effective rate of treatment in the study group was 93.75% higher than that in the control group (P＜0.05); after 12 weeks of treatment, the levels of 2hPG, FBG and HbA1c in the study group were lower than those in the control group (P＜0.05); after 12 weeks of treatment, the HAMD score of the study group was lower than that of the control group (P＜0.05); after 12 weeks of treatment, the levels of Cor, ACTH and Hcy in the study group were lower than the control group (P＜0.05); the incidence of adverse reactions in the study group was 8.33% compared with 4.17% in the control group, and the difference was not statistically significant (P>0.05). Conclusion The combination of escitalopram and insulin has a significant effect in the treatment of T2DM patients with depression, which can improve their depressive symptoms, reduce blood glucose levels, and promote the improvement of HPA axis function, thereby reducing serum Cor, ACTH, and Hcy levels, with high safety.
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