Diabetes and Depression - Complications of Diabetic Depression

Diabetes and Depression
By National Institute of Mental Health
May 9, 2008
Psych Central

Depression can strike anyone, but people with diabetes may be at a greater risk. Diabetes is a serious health concern that afflicts an estimated 16 million Americans. Treatment for depression helps people manage symptoms of both diseases, thus improving the quality of their lives.

Several studies suggest that diabetes doubles the risk of depression compared to those without the disorder. The chances of becoming depressed increase as diabetes complications worsen. Research shows that depression leads to poorer physical and mental functioning, so a person is less likely to follow a required diet or medication plan. Treating depression with psychotherapy, medication, or a combination of these treatments can improve a patient’s well-being and ability to manage diabetes.

Causes underlying the association between depression and diabetes are unclear. Depression may develop because of stress but also may result from the metabolic effects of diabetes on the brain. Studies suggest that people with diabetes who have a history of depression are more likely to develop diabetic complications than those without depression. People who suffer from both diabetes and depression tend to have higher health care costs in primary care.

Despite the enormous advances in brain research in the past 20 years, depression often goes undiagnosed and untreated. People with diabetes, their families and friends, and even their physicians may not distinguish the symptoms of depression. However, skilled health professionals will recognize these symptoms and inquire about their duration and severity, diagnose the disorder, and suggest appropriate treatment.

The Basics About Depression
Depression is a serious medical condition that affects thoughts, feelings, and the ability to function in everyday life. Depression can occur at any age. Research studies estimate that 6 percent of 9- to 17-year-olds in the U.S. and almost 10 percent of American adults, or about 19 million people age 18 and older, experience some form of depression every year. Although available therapies alleviate symptoms in over 80 percent of those treated, less than half of people with depression get the help they need.

Depression results from abnormal functioning of the brain. The causes of depression are currently a matter of intense research. An interaction between genetic predisposition and life history appear to determine a person’s level of risk. Episodes of depression may then be triggered by stress, difficult life events, side effects of medications, or other environmental factors. Whatever its origins, depression can limit the energy needed to keep focused on treatment for other disorders, such as diabetes.

The Basics About Diabetes
Diabetes is a disorder that impairs the way the body uses digested food for growth and energy. Most of the food we eat is broken down into glucose, a form of sugar that provides the main source of fuel for the body. After digestion, glucose passes into the bloodstream. Insulin, a hormone produced by the pancreas, helps glucose get into cells and converts glucose to energy. Without insulin, glucose builds up in the blood, and the body loses its main source of fuel.

Type 1 diabetes is when the immune system destroys the insulin-producing beta cells of the pancreas. This form of diabetes usually strikes children and young adults, who require daily or more frequent insulin injections or using an insulin pump for the rest of their lives. Insulin treatment, however, is not a cure, nor can it reliably prevent the long-term complications of the disease. Although scientists do not know what causes the immune system to attack the cells, they believe that both genetic factors and environmental factors are involved.

Type 1 diabetes accounts for about 5 to 10 percent of diagnosed diabetes in the United States, occurs equally in males and females, and is more common in Caucasians. Symptoms include increased thirst and urination, constant hunger, weight loss, blurred vision, and extreme fatigue. If not treated with insulin, a person can lapse into a life-threatening coma.

Type 2 diabetes, which accounts for about 90 percent of diabetes cases in the United States, is most common in adults over age 40. Affecting about 6 percent of the U.S. population, this form of diabetes is strongly linked with obesity (more than 80 percent of people with type 2 diabetes are overweight), inactivity, and a family history of diabetes. It is more common in African Americans, Hispanic Americans, American Indians, and Asian and Pacific Islander Americans. With the aging of Americans and the alarming increase in obesity in all ages and ethnic groups, the incidence of type 2 diabetes has also been rising nationwide.

Type 2 diabetes is often part of a metabolic syndrome that includes obesity, high blood pressure, and high levels of blood lipids. People with type 2 diabetes first develop insulin resistance, a disorder in which muscle, fat, and liver cells do not use insulin properly. At first, the pancreas produces more insulin, but gradually its capacity to secrete insulin falters, and the timing of insulin secretion becomes abnormal. After diabetes develops, insulin production continues to decline.

Symptoms include fatigue, nausea, frequent urination or infections, unusual thirst, weight loss, blurred vision, and slow healing of wounds or sores. Some people have no symptoms at all. Researchers estimate that about one-third of people with type 2 diabetes don’t know they have it.

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