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April 2015 | Read this issue and more at www.healthandwellnessmagazine.net |
Depression
Linked to Diabetic
Complications
Psychosocial factors play
critical role in treatment
By Dr. Tom Miller, Staff Writer
Diabetes mellitus is a chronic,
lifelong condition that affects the
body’s ability to use the energy found
in food. There are three major types
of diabetes, according to WebMD
(www.webmd.com): type 1, type
2 and gestational diabetes. Each
type has something in common.
The healthy body breaks down the
sugars and carbohydrates we eat
into a special sugar called glucose.
Glucose is the substance that fuels
the cells in our bodies. At the same
time, cells need insulin, a hormone,
in the bloodstream in order to take
in the glucose and use it for energy.
With diabetes, the body doesn’t make
enough insulin, can’t use the insulin it
does produce or both.
Since the cells can’t take in the glucose, it builds up in the blood. High
levels of blood glucose can damage
the tiny blood vessels in the kidneys,
heart, eyes or nervous system. That’s
why diabetes – especially if left
untreated – can eventually cause kidney disease, heart disease, blindness,
stroke and damage to nerves in the
feet. Complications may develop with
diabetes even when risk factors such
as blood sugar level and blood pressure have been controlled. Following
your treatment regimen to control
your blood sugar levels is an important part of your treatment. All diabetes complications can require special-
ized medical treatment, depending on
their severity.
Common symptoms of diabetes
and complications involving more
than one of these symptoms can
develop at any stage of diabetes.
Symptoms of diabetes often include
one or more of the following: frequent urination, heavy thirst, frequent hunger, fatigue, blurry vision,
cuts and bruises that are slow to heal,
weight loss while eating more and
a tingling, pain or numbness in the
hands and/or feet.
One additional complication to
the physical symptoms of diabetes
is change in mood and feelings of
depression. Psychosocial factors play
a critical role in all types of diabetes.
Depression may have special clinical
relevancy in diabetes through its purported association with poor glycemic control and decreased adherence
to treatment modalities.
Diabetes can involve a combination of psychological, environmental,
genetic and biological factors. People
with diabetes are at risk of suffering
from psychological disorders such
as anxiety, depression and transitions (Miller 2010). Depression may
worsen the health complications that
often go along with type 2 diabetes,
according to a new study by Canadian
researchers who followed more than
1,000 patients for five years. The
researchers found those with multiple
episodes of low-level depression
were nearly three times more likely
than those without depression to
have more disability, such as reduced
mobility, poor self-care and worse
quality of life. Dr. Norbert Schmitz
of McGill University’s Douglas
Mental Health University Institute in
Montreal led the study.
Most research to date has focused
on the role of major depression and
poor health outcomes for diabetes
patients, but Schmitz and his colleagues wanted to know if minor
depression symptoms carried the
same risks. Minor depression is a
form of chronic stress. The researchers found as the number of episodes
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of minor depression increased for
the patient, the risk of impaired
health and quality of life grew as
well. For participants with one minor
depression episode, the rate of poor
functioning in daily activities such as
work, domestic responsibilities and
self-care was 50 percent higher than
among those with no depression. For
patients with four or more bouts of
minor depression, the risk of poor
functioning was almost 300 percent
greater and the risk of impaired
health-related quality of life was nearly 250 percent greater than for those
without depression.
Past research has found nearly one
fifth of people with type 2 diabetes in
the United States experience major
depression, which is almost twice the
rate seen in the general population.
Some studies also link the combination of type 2 diabetes and dep