The Relationship of Diabetes with Depression
Author: Ham Pato
Presence of diabetes in patients with depression and symptoms of depression more often than in the entire population. This association may be due to increased risk of depression in patients with diabetes, increased risk of diabetes in patients with depression, or both.
Several factors associated with depression symptoms, including obesity, healthy lifestyle (sedentary, high-calorie, etc.). And activation of the neuroendocrine system and inflammatory responses may cause insulin resistance and diabetes onset. Furthermore, the diagnosis of diabetes or suffer the burden of its complications can also cause depression.
One study conducted repeated measurements of fasting blood to assess whether depressive symptoms predict the occurrence of diabetes mellitus type 2 (dm2) and whether participants with T2DM are likely to present significant depressive symptoms and compared with the population without neither of the two at the beginning of the disease.
Univariate analysis showed that the incidence of T2DM in a 3.2-year period was 22.0 per 1,000 person-years in participants who had symptoms of depression and 16.6 per 1,000 person-years in those without symptoms of depression (HR, 1.37 , 95% CI, 1,02-1,90). There was a significant relationship between the level of CES-D staggered score every 5 levels and the incidence of T2DM.
Incidence levels of depression symptoms during 3.1 years was 36.8 in participants with fasting glucose, 27.9 in people with impaired fasting glucose, 31.2 for those not treated with DM and 61.9 in those treated dm2 per 1000 person-years.
These findings indicate that individuals with symptoms of depression have an increased risk of T2DM simple during follow-up, regardless of socio-economic, demographic and metabolic. This association seems not caused by the lifestyle features. In the opposite direction, the authors found that in people without symptoms of depression at baseline, treated dm2 is associated with increased susceptibility to develop symptoms of depression, regardless of body mass index, and social factors of economic and comorbidities.
Depressed people are not likely to meet dietary recommendations and exercise to lose weight, the aspects that contribute to metabolic syndrome and obesity. There are also people are more susceptible to smoking. But to make adjustments for all these variables showed that by itself is not sufficient to explain the relationship between symptoms of depression and diabetes.
One element that could justify this relationship is the activation of the hypothalamic-pituitary-adrenal axis in people with depression. This activation causes increased pro-inflammatory molecules of the established risk factors for T2DM. However, adjustment for these variables of inflammation, did not substantially change the association.
The findings of the authors of the association between depressive symptoms and treated dm2 but untreated diabetes mellitus showed that psychological stress associated with the treatment of T2DM can lead to increased symptoms of depression. Also, patients with levels of dm2 treated with higher comorbidities associated with T2DM can cause symptoms of depression. However, in this study, adjustment for variables including comorbidity dyslipidemia, hypertension and microalbuminuria, did not explain the relationship between dm2 and depression.
Very important
Biological mechanisms of depression and related dm2 not explained. However, this research contributes to swell the vast information in the scientific literature that shows a two-way relationship between these two important diseases. Future studies can determine whether interventions to modify lifestyle factors associated with depression will complement prevention strategies in dm2.