People who have diabetes are twice as likely to suffer from depression as people who do not have diabetes. In fact, from the time someone is diagnosed with diabetes, they have a 1 in 4 chance of developing depression (if they don’t already have it). This has prompted the American Diabetes Association to recommend psychological assessments as a routine part of diabetes management (1).
Depression can have a detrimental effect on a patient’s engagement in their own care and their adherence to treatment protocols. A 2008 study in Diabetes Care analyzed 47 previous studies of people with type 1 or type 2 diabetes, and found that depression kept them from seeing their doctor, following a diet, and taking medication as directed resulting in complications and increased mortality (2). In another study, researchers found that clinically depressed people with diabetes were three times as likely to die over the 20-year study as those without depression, even after accounting for factors such as age, blood pressure, and smoking (3). This suggests that depression treatment should be a crucial component of any treatment plan.
Studies have also shown a correlation between existing depression and increased insulin resistance leading to the onset of Type 2 Diabetes. Data suggests that depression in the non-diabetic population is independently associated with up to a 60% increased prospective risk of developing Type 2 Diabetes (4) and that a history of depression may be a risk factor for the development of gestational diabetes mellitus (GDM). These studies suggest that depression may be a greater risk factor for diabetes than is diabetes for depression (5).
Depression Doubles the Risk of Developing Type 2 Diabetes and Accelerates Development of Diabetes Complications.
Understanding depression as a medical risk factor for diabetes is an important preventive measure. Screening for and treating depression in people with prediabetes and/or type 2 diabetes may enhance glycemic control and insulin sensitivity, slowing disease progression and reducing comorbid complications (6). However, nearly two-thirds of depressed diabetic patients do not receive antidepressant treatment (7).
Most diabetic patients who are experiencing symptoms of depression will seek care from their primary care physician (PCP) rather than seeking care from a mental health professional. Despite their best efforts, many primary care practices struggle to properly diagnose and treat their depressed patients.
Several barriers can hinder diagnosis and treatment in the primary care setting (8):
Additional examples of depression screening tools include but are not limited to:
Effective Treatments For Depression in Diabetes (9)
Other Abnormal Glucose
Impaired Fasting Glucose
Abnormal Glucose with Pregnancy
Impaired Glucose Tolerance (oral)
Fasting Plasma Glucose Test
Oral Glucose Tolerance