Useful Research – Depression and Diabetes
Stress, Anxiety and Depression
Useful Research – Depression and Diabetes
Research in young adults with Type 1 diabetes
Research in Australia surveyed 92 young adults with Type 1 diabetes with an average age of 22 and found that 35% of them reported depressive symptoms. Importantly those with depression tended to have poorer blood glucose control than those without depressive symptoms, so putting those with depression at greater risk of complications such as cardiovascular disease. [Diab Med, 2008;25:91-6] The study concluded that as many young adults reported significant levels of psychological distress, health teams caring for young adults with Type 1 diabetes should provide psychological assessment and support.
Research in older people with diabetes
Research in Canada has shown that people with heart disease maybe at risk of further attacks if they suffer from depression or anxiety. People with diabetes are more at risk of developing heart disease, so this study again emphasises the importance of treating depression in people with heart disease as well as those with diabetes.
[Arch Gen Psychiatry 2008;65:62-71]
Research in the US looking at the relationship between diabetes and depression found that depression treatment reduces mortality by half in older people with diabetes. Again this emphasises the need to diagnose and treat depression in people with diabetes.
[Diab Care 2007,30:3005-10]
Depression link with poor blood glucose control
Research has also shown that in young people with Type 1 diabetes, depression tended to be linked to poorer blood glucose control. This could be through hormonal changes but it is thought that the most likely cause is the negative effects that depression has on people making self-management of their diabetes more difficult with the following effects:
- lack of exercise
- increased smoking and alcohol consumption
- lack of or poor blood glucose monitoring.
Research using questionnaires has shown that depression in people with both Type 1 and Type 2 diabetes may have the following effects:
- They are less likely to eat the types and amounts of food recommended.
- Less likely to take all their medications.
- Less likely to function well, both physically and mentally.
- Greater absenteeism from work.
[Archives of Internal Medicine, Nov 27, 2000]
Note: Depression is also associated with increased weight and obesity and depression itself can cause Type 2 diabetes.
Injection related anxiety in insulin treated patients
This study set out to look at whether the presence of injection related anxiety and phobia influences compliance, glycaemic control and quality of life in people with diabetes. 115 unselected insulin treated people, 80 with Type1 and 35 with Type 2 diabetes, completed a standardised questionnaire providing injection anxiety scores and general anxiety scores. The results showed that in14% of cases injections had been avoided because of anxiety and 42% expressed concern at having to inject more frequently. A significant correlation was found between injection anxiety scores and general anxiety scores. The latter was significantly associated with injection avoidance and expressed concern at increased injection frequency. No significant correlation was seen with HbA1cs and either type of anxiety. The authors conclude that symptoms relating to injection anxiety and phobia have a high prevalence in an unselected group of people with diabetes and are associated with higher levels of general anxiety.
Diabetes Res Clin Pract 1999 Dec;46 :239-46
Prevalence of symptoms of depression and anxiety in a diabetes clinic population
While waiting for their routine hospital appointment adults with Type 1 and Type 2 diabetes were asked to fill in a questionnaire to measure psychological symptoms and the perceived need for psychological support. From the patients records the presence of complications was recorded and the HBA1 was also recorded. The response rate was high [96%]. The presence of psychological symptoms was also high with 28% of the participants reporting moderate to severe levels of depression or anxiety or both. Men were more likely to report moderate to severe depression symptoms and women more moderate to severe anxiety symptoms. There was a significant link between depressions and poor gylcaemic control, as measured by the HbA1, in men but not in women. A third of the participants reported that at that moment they would be interested in receiving counselling if it was currently available in the diabetes clinic. The authors conclude that there is a significant proportion of people who require psychological support which, if available, might help to improve glycaemic control and so overall wellbeing.
Diabetic Medicine, March 2000, 17; 198-202