People with diabetes have double the risk of developing depression. Depression and diabetes also appear to increase the risk of developing further complications such as cardiovascular disease and those who suffer both are more likely to die at an early age. But why?
Depression is thought to be associated with blood glucose control either through hormonal dysregulation or poor diabetes self-care such as smoking and alcohol intake and poor glucose monitoring.
Some of the symptoms of diabetes are similar to those of depression. For example, changes in sleep patterns, fatigue, changes in weight and appetite. This may account for some reasons why depression goes largely undetected in people with diabetes, but some estimates suggest that up to three quarters of cases of depression remain undetected. Part of the reason may be under-reporting by those affected, but there is also the strong possibility of under-diagnosis, or of depression being viewed as an inevitable consequence of having diabetes.
Studies to date suggest that diabetics with a history of depression are far more likely to develop additional complications. The co-existence of depression and diabetes has the greatest negative effect on quality of life when compared with diabetes, depression or other chronic conditions alone.
Various agencies have recommended screening for depression. In the UK for example all doctors are now required to ask, "during the last month, have you been bothered by feeling down, depressed or hopeless?" And, "Have you often been bothered by having little interest or pleasure in doing things?"
When depression is diagnosed it seems clear that treatment can be effective. There remains surprisingly little research into the treatment of depression in people with diabetes but what exists points to anti-depressant medication and cognitive behavior therapy as effective. As depressive symptoms subside an additional benefit seems to be better self-care in the monitoring of blood glucose control.
Lloyd C (2008) The Effects of Diabetes on Depression and Depression on Diabetes. Diabetes Voice. March 2008. 53. 1. 23-26.
Published On: February 08, 2010