Depression and diabetes are theoretically separate conditions, but their coexistence in one patient is more frequent than might be expected. The coexistence of depression and diabetes is very serious because it can lead to significant neglect of the medication prescribed for the diabetic. What symptoms should lead to a suspicion of depression in a diabetic patient and what specialist should you seek help from?

Diabetesis associated with disorders of carbohydrate metabolism,depressionis in turn classified as mental disorders from the group of affective disorders (mood disorders) . Theoretically, it would seem that there should be no connection between these diseases, in practice it turns out that they have a lot in common.

As evidence, we can cite the statistical data, according to which, among diabetic patients, various depressive symptoms are observed in 3 out of 10 of them, while full-blown depression is diagnosed in up to 10% of all diabetic patients.

Some of the relationship between diabetes and depression is known, while others are still under investigation. However, some aspects already seem quite clear - diabetes can lead to depression, but depression can also increase the risk of diabetes.

How can diabetes lead to depression?

Factors that increase the risk of depression are chronic diseases, incl. diabetes. As in the case of type II diabetes, patients sometimes achieve remission and normalize the carbohydrate metabolism, the course of type I diabetes is much worse.

So the very fact that diabetes is a chronic disease predisposes patients suffering from it to develop mood disorders. It should be added, however, that there are many more factors predisposing to mood disorders in diabetics.

Among them, there are changes in lifestyle related to diabetes. He althy people may think that measuring blood glucose levels is not an extremely strenuous activity - but what if the patient has to take measurements several times a day, and sometimes even at night? The need for constant monitoring of your he alth may increase the risk of depression. To this must be added other factors, such as permanent restrictions in the choice of dishes - partdiabetics selects insulin doses depending on how much of the so-called they eat carbohydrate exchangers during a given meal.

People with diabetes are also aware that it is an extremely dangerous disease that can lead to such serious problems as significant visual disturbances or an increased risk of a heart attack. Knowing about such dangers may also be a factor that increases the risk of developing depression.

A particularly high risk of affective disorders occurs in particular groups of diabetics:

  • women (even more so in postmenopausal women)
  • in whom the disease lasts for many years
  • with complications from diabetes
  • experiencing little support from the environment
  • living in poverty
  • whose blood glucose levels (even with appropriate treatment) are still out of balance
  • youngest and oldest sick

IMPORTANT! According to statistics, the risk of developing depression in people with diabetes is increased by two or three times compared to people without glycemic disorders.

Problem

In one of the studies conducted in the United States, a group of over 7,000 patients diagnosed with depression was observed over a period of several years. After completing the research and carrying out appropriate analyzes, it turned out that patients suffering from depression had a 17% increased risk of developing diabetes.

Effect of depression on the risk of developing diabetes

There is also the opposite relationship to the one described above - people suffering from depression have an increased risk of developing diabetes. Here, there are definitely fewer potential mechanisms of such a correlation, but there are already some hypotheses explaining why depression would increase the risk of glycemic disorders.

One of the explanations is that in some depressed patients there is a significant decrease in physical activity, in addition, people with this disorder may start to eat more - both of these phenomena can lead to obesity. Excessive body weight can lead to insulin resistance, which is recognized as a risk factor for the development of type II diabetes.

Another potential mechanism by which depression may increase the risk of developing diabetes is the influence of mood disorders on the emergence of hormonal disorders. Well, in the case of depression, the patient may experience significant stress, which may stimulate the hormonal axis of the hypothalamus-pituitary-adrenal glands. The final effect of stimulating these endocrine glands may be increased secretion of cortisol, i.e.a hormone that antagonizes insulin and increases blood glucose levels.

Worth knowing

Symptoms of Diabetic Depression

Depressive disorders may occur in different ways in individual patients, however, there are some symptoms that should especially raise the suspicion of depression in a diabetic patient. Examples of them include:

  • anhedonia (loss of happiness)
  • significant pessimism concerning both one's own life and the world as a whole
  • loss of previous interests
  • constant feeling of fatigue
  • appetite disturbance (it can both increase and significantly decrease)
  • sleep disorders (in the form of both insomnia and excessive daytime sleepiness)
  • avoiding other people's company
  • problems with concentration, attention and memory
  • suicidal thoughts and sometimes even attempted suicide

Depression in people with diabetes: looking for the cause

There are still many links between depression and diabetes that remain unclear. Scientists are still working to find these connections. One of the findings concerns a gene called DISC1. Earlier it was noted that disturbances in this gene can influence the occurrence of mental problems such as schizophrenia and depression.

In studies on mice, however, it was found that DISC1 disorders affect not only the psyche. It turned out that when this gene is mutated, there is an increased death of beta cells of the pancreatic islets - this led to reduced insulin secretion in mice, and consequently to the occurrence of carbohydrate metabolism disorders. These reports are so far more of a clue than a specific route, but they can probably contribute a lot to understanding why depression quite often coexists with diabetes.

Depression in people with diabetes: the consequences

The coexistence of depression and diabetes in one patient is a serious matter. The effects of depressive disorders in diabetics can be tragic. A patient who feels powerless and lacks strength for anything may simply begin to neglect his treatment.

As mentioned, regular blood glucose monitoring or insulin administration can be quite burdensome, so patients with severe mood disorders may simply avoid them. This is a definitely unfavorable phenomenon, because - in people who need insulin - it is the use of this hormone that is basically the only way to regulate glycemia.

The development of depression in a diabetic can also make the patientstop following a diabetic diet, and discontinuing certain nutritional restrictions can also definitely worsen the course of diabetes in people suffering from it.

Depression in diabetics: where to get help?

The most favorable situation would be if a patient suffering from diabetes and depression was under the care of both a diabetologist and a psychiatrist.

The first of these specialists will be able to properly guide the treatment of carbohydrate disorders. The psychiatrist, on the other hand, will be able to choose drugs that are appropriate for a patient with diabetes - it is necessary, after all, to treat depression with such preparations that will not impair the carbohydrate metabolism.

A specialist in psychiatry deals with psychotropic drugs on a daily basis, so he will be the one to choose the safest drugs for a diabetic patient.

It should be emphasized, however, that treating depression in patients with diabetes is not only pharmacotherapy - patients may be offered psychotherapy alone, or a combination of psychotherapy with pharmacotherapy.

About the authorBow. Tomasz NęckiA graduate of medicine at the Medical University of Poznań. An admirer of the Polish sea (most willingly strolling along its shores with headphones in his ears), cats and books. In working with patients, he focuses on always listening to them and spending as much time as they need.

Category:

Psychiatry