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The Relationship Between Depression, Distress, and Diabetes

0 2 years ago

Depression is common in people with diabetes. In the United States, depressive symptoms in people with either type 1 diabetes (T1D) or type 2 diabetes (T2D) is approximately 30%, and 11% show signs of major depressive disorder [MDD]. A 2020 study found similar rates of depression in people with diabetes in other countries as well. 1 Additionally, depression was not limited to people with a confirmed clinical diagnosis of diabetes. Research published in 2021 in the American Journal of Psychiatry reported a positive association between prediabetes and MDD (hazard ratio [HR], 2.66; 95% CI, 1.13-6.27).2

Potential diabetic and depression pathways

Although the precise underlying mechanisms remain unclear, the association between diabetes and depression appears to be bidirectional. Experts have proposed insulin resistance might represent a shared factor in the pathogenesis of both depression and severity of diabetes, with recent findings showing insulin resistance predicted MDD at a 9-year follow-up in patients with no previous history of depression.2-3

Contributing factors of the potential influence of depression on people with diabetes includes “poor health behaviours such as low self-care and treatment adherence, as well as by psychobiological changes such as dysregulation of the autonomic nervous system and increased inflammatory processes due to depressive symptoms, which may lead to glycemic variations,” according to a paper written by Jung et al in 2020.4


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