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Diabetes and depression can affect anyone’s quality of life, in a number of ways, and both conditions appear to be linked. While there are no studies that determine the causes of that relationship, there are ways to understand why the two could go hand in hand:
- Daily management of diabetes can be stressful: you have to control what you eat and when, measure your blood glucose (sugar) levels, lose weight (if you’re overweight), visit the doctor frequently and more. It’s a lot to deal with!
- The complications of diabetes can cause stress and depression.
- Depression can lead to making decisions that are bad for your diabetes, such as eating an unhealthy diet, exercising less, gaining weight and smoking. These are all factors that increase the risk of developing diabetes complications.
- If you are depressed, you may lose the ability to communicate and think clearly, which can also interfere with the management of your diabetes.
To all of this, now, add the results of a new study by researchers at the University of Washington School of Medicine, in Seattle, which find that depression may increase the risk of hypoglycemic episodes (low blood sugar) in people with diabetes.
To reach these conclusions, which appear in the journal Annals of Family Medicine, researchers analyzed five years of data from more than 4,100 adult patients who had had diabetes for an average of ten years.
Most of the participants (96 percent) had type 2 diabetes, about a third of them used insulin to control their diabetes and only 1.4 per cent had experienced complications from the disease. About 500 participants were found to have suffered from depression during the period of the study.
During the previous five years, the eight percent of the participants who had had depression and diabetes reported episodes of hypoglycemia. By contrast, only three percent of the diabetics who had not suffered from depression reported having one of these episodes.
Also, during the five years of the study, nearly 11 percent of those participants with both depression and diabetes suffered severe episodes of hypoglycemia, almost double the six percent in diabetics who did not report depression.
Based on these findings, the study concludes that people with both diabetes and depression had a risk 42 percent higher of suffering from episodes of hypoglycemia and were 34 percent more likely to have a greater number of these episodes.
Remember that diabetes is a disease in which your body does not produce enough insulin or the insulin that it does produce does not work well. Insulin is a hormone produced in the pancreas, an organ located in the abdomen below the stomach. Insulin helps the blood sugar (glucose), from the food that we eat and digest, enter the cells and become energy. Without enough insulin or with insulin that does not work well, the sugar cannot enter the cells and builds up in the blood.
To control diabetes, some people have to take medication (pills) and / or inject insulin, in addition to monitoring their diet and physical activity levels. Occasionally, these medicines or insulin can lower blood sugar level too far, causing hypoglycemia. When that occurs, the body and brain cannot function properly. When the blood sugar level drops too low a person may faint. In severe cases, their lives may be endangered.
It is very important that people with diabetes keep a proper balance between medication and lifestyle, which includes not only eating a healthy and balanced diet (at the right times and without skipping any meals), but also participating in physical activity, and controlling stress and mood.
A depressed diabetic, as shown in the study, faces greater difficulties in maintaining a stable blood sugar level. Therefore, you should be alert for signs of depression. Don’t confuse it with simple sadness or melancholy. Depression causes several symptoms that you should recognize:
- Loss of interest in things you enjoyed doing before.
- Changes in sleep patterns or problems sleeping.
- Sadness and despair, especially in the morning.
- Difficulty concentrating and making decisions.
- Changes in appetite that can lead to rapid weight loss or gain.
- Head and backaches with no apparent explanation.
- Thoughts of suicide.
Let your doctor know if you notice any of these symptoms, to help you break the vicious cycle of diabetes and depression. Remember that they’re a dangerous combination: together they double the risk to your health. The sooner you get out of a depressed state, the easier it is to control your diabetes. Take action!
By Aliza Lifshitz M.D.
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