Depression can develop among people who have been diagnosed with diabetes, and it can impact the treatment of diabetes by affecting the therapies that are targeting the glucose control (glycemic control) and the complications associated with the progression of diabetes. The progression of diabetes has been associated with high blood sugar levels (hyperglycemia), large and small vascular complications, and an increased risk of death. The treatment of depression among persons who have diabetes is lacking, largely because it is underdiagnosed.
Studies have shown that the chance of becoming depressed increases after being diagnosed with diabetes, and as the complications that go along with diabetes progress. After depression has settled in, studies have also shown that persons with diabetes and depression are less active physically and have poorer mental functioning. As a result, a patient with diabetes and depression is less likely to follow medication plans and recommended diet as well as keeping sugar levels under controll.
The causes that underlie the association between depression and diabetes are not well understood at the molecular level yet; however, research has shown that depression may develop due to elevated stress levels, an impaired immune system, and the metabolic effects that diabetes can have on the brain.
As already noted, depression in persons with diabetes can impact the therapy for treating the complications of the disease. Depression can also impact the psychological, physical (ability to walk, job, run, work) and social (dating, having a family, depending on other family members for financial support) outcomes after a diagnosis of diabetes. Another complication that has been associated with the development of depression in diabetic patients is an increased use of tobacco, when compared to other persons who have diabetes but have not yet developed depression. Diabetes and depression can also lead to lower satisfaction with one's treatment for diabetes.
Research has shown that most antidepressants have been effective in treating depression in persons with diabetes. Recent studies that looked at people who were diagnosed with Type 1 and Type 2 diabetes showed an increased risk for elevated levels of glucose levels and more complications with the vascular system in these patients.
If you have diabetes and struggle with depression, talk to your medical provider.
Diabetes statistics. NIH Pub. No. 99-3892. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases, March 1999.
Anderson RJ, Lustman PJ, Clouse RE, et al. Prevalence of depression in adults with diabetes: a systematic review. Diabetes, 2000; 49(Suppl 1): A64.
Treatment of Depression in Diabetes: An Update
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