Dear all,
I would like to touch on a sensitive issue in our society and no its not the Double D’s you’re thinking about. These here are Diabetes and Depression. The last couple of months we have lost a few colleagues to depression and its sad how this topic is still not getting enough air time. Looking at depression and diabetes, there are two aspects;
1. Diabetes patients have a higher risk of depression 2. Depression worsens diabetes care.
Research has shown that at least 30% of Type 1 diabetes patients and overall up to 50% of diabetics suffer from a depressive or anxiety illness. This can range for early mild symptoms of feeling sad, unwanted or loss of energy to function. To more severe symptoms of suicidal thoughts and tendencies. Diabetes as a diagnosis and its continued management requires a lot of input and work from the patient. A complete lifestyle change, frequent doctor visits, several tests and all the medication can be a lot for most people. This on its own can overwhelm patients and with no good support system, it can trigger depression.
Studies show especially in type 1 diabetes, stress can result in uncontrolled sugars leading to dissatisfaction to the patient and in turn becomes a vicious cycle and feelings of not being good. Several small studies have shown a direct link between high blood glucose and HBA1C levels associated with depression. In this meta-analysis, it was shown that depression raises ones’ blood glucose which in turn elevates HBA1C. An increase in HBA1C has been shown in one of the largest studies in diabetes (UKPDS) to be directly associated with worsening of complications. All this is what a diabetic patient thinks of throughout, “are my sugars good?”.
People though, should not confuse simple normal reactions to an illness as depression. For example, it is normal to feel low mood when afflicted with a disease or sad news in your life but generally people bounce back from this and would normally not affect ones’ daily function. It is therefore important to keep checking in on our patients and ensure their mental state is ok.
Doctors should have an open relationship with their patients so they can share any stresses they are going through. A complete diabetes centre should have a diabetes educator and a counselor on board to help patients through their journey. It is without doubt a strong support system at home is one of the best ways to prevent depression among our patients. If all doesn’t work, patients should mention to their doctors their emotional status so the right referral to a psychologist or psychiatrist is done at an early stage.
Next time you come across a diabetic patient, don’t just ask them about their blood sugars, ask them how they are!If you have any questions, feel free to comment below!
Kind regards:
Dr. Salwa Shahbal.
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