Depression more common among diabetes patients

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Depression more common among diabetes patients; Poor mental state worsens
complications of disease
Iris Winston 
Ottawa Citizen , Nov. 25, 2008
Diabetes and depression often go hand in hand.
Mary Baker was diagnosed with type 2 diabetes in 1998 and, while managing
her condition and its complications, she has also had to cope with periods
of depression.
“I am depressed,” says the 77-year-old Almonte, Ont. resident, “and I get
more depressed when my diabetes is out of whack. But I don’t know if that is
because of the diabetes or because of my personal circumstances.”
“It’s something of a chicken-and-egg issue of which comes first,” says Jeff
Johnson, Canada research chair at the University of Alberta School of Public
Health, who has studied the connection between diabetes and depression for a
number of years.
“We have found depression to be about twice as common in people with
diabetes and people with diabetes are at increased risk of depression,
particularly after accumulating long-term complications.”
The results of a study by Mr. Johnson and fellow researchers published in
the journal Diabetes Care notes that people newly diagnosed with type 2
diabetes are 30 per cent more likely to have had a previous history of
depression than those without diabetes.
“Depression is often overlooked in people with chronic medical conditions,”
Mr. Johnson says.
“We have found that depression, because of its effects on people’s
lifestyles — they become sedentary and have poor dietary habits —
increases their risk of developing diabetes.
“Also, having diabetes and needing long-term medication can lead to
depression. It can go in either direction.”
Dr. Barry Simon, psychiatric consultant at the Leadership Sinai Centre for
Diabetes at the Mount Sinai Hospital in Toronto, says depression puts a
strain on the whole body.
“Diabetes is worsened by sleep disorders and by a lot of things that are
stress-related. Certainly, a person who has type 2 diabetes is much more
prone to depression and anxiety.”
Treating depression should go hand in hand with balancing glucose levels and
seeking aggressive reduction of cholesterol levels in diabetes treatment,
says Dr. Simon.
“You want to bring down cholesterol and bring down blood pressure and I
would add that you want to bring down the depression.
“You want to improve the mood of people with diabetes, because there is some
indication that when someone with type 2 diabetes is depressed, their
chances of having a heart attack goes up one or twofold. It’s another risk
“Both conditions — diabetes and depression — put people at an increased
risk of bad outcomes,” says Mr. Johnson. “Together they are a double
His research, which included 32,000 case studies of patients in
Saskatchewan, found that people who have the combination of type 2 diabetes
and minor depression have a 67 per cent greater risk of dying, while people
with both diabetes and major depression have a 130 per cent greater chance
of dying, compared to those who have type 2 diabetes alone.
Possible reasons for the higher fatality rates include changes in lifestyle
and side effects of some of the medications used to treat depression, says
Mr. Johnson.
– – – Diabetes Facts
– More than 250 million people around the world have diabetes.
– Diabetes is the leading cause of blindness in working-age adults, and the
leading cause of kidney failure and of non-traumatic amputations.
– Individuals with diabetes also have two to four times more heart disease,
including heart attacks and strokes. It is estimated that heart disease
occurs 10 to 12 years earlier in someone with diabetes than in non-diabetic
– Diabetes can be associated with a number of mood disorders, including
depression and anxiety.
– To prevent complications, it is important to target appropriate glucose,
blood pressure and cholesterol levels.
Source: Dr. Vincent Woo of the Canadian Diabetes Association
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