Even though the two conditions would seem to be unrelated, people who have diabetes should be screened for depression, and people who have depression should be screened for diabetes.
People with type 2 diabetes are more likely to experience depression symptoms than their peers. At the same time, data suggest that people who are depressed have an increased risk of developing type 2 diabetes.
Researchers have offered a number of explanations for the link between depression symptoms and type 2 diabetes, including:
- A diabetes diagnosis leads to depression. Many people experience depression symptoms after receiving the diagnosis of a chronic condition like diabetes.
- The physical impact of depression can trigger diabetes. Depression affects your body’s response to stress and increases inflammation, both of which can make it difficult to process sugar and insulin correctly. This in turn can promote the development of diabetes.
- Antidepressants can cause type 2 diabetes. A study of over 3,000 adults participating in the Diabetes Prevention Program suggests that antidepressants may make it harder for people to control blood sugar levels. This doesn’t mean that people with depression should stop taking their medications, but their blood sugar levels should be monitored more closely. Additional research is needed to clarify this issue.
- Certain lifestyle choices increase the risk of both conditions. A sedentary lifestyle and a high-calorie diet put you at greater risk of both depression and diabetes.
- Depression makes it harder to manage diabetes. A study of 2,902 Native Americans showed that those who were depressed and had diabetes were less likely to keep their blood sugar under control.
Depression and Diabetes: What Does the Research Say?
In a study published in the Journal of the American Medical Association in 2008, researchers at Johns Hopkins University School of Medicine in Baltimore determined that the risk of type 2 diabetes rises as depression symptoms increase. Likewise, they found that people with type 2 diabetes were almost twice as likely to have depression symptoms as those who had untreated, and likely undiagnosed, type 2 diabetes.
“Having depression increases an individual’s risk of developing type 2 diabetes, and having treated type 2 diabetes increased an individual’s risk of developing depression,” says study author Sherita Golden, MD, MHS, assistant professor of medicine and epidemiology at Johns Hopkins.
The results from Dr. Golden’s study build on the foundation of prior work exploring the link between diabetes and depression.
“Previous studies have shown that people who have diabetes and depression are more likely to have hyperglycemia or poor blood sugar control. We know that individuals with depression are less likely to exercise, consume more calories, and are less adherent [to] their medication schedule, all of which can contribute to poor blood sugar control in the setting of diabetes,” Golden explains.
Despite the data, there are no national recommendations for screening people with diabetes for depression, or for screening people with depression for diabetes.
“The data suggests that individuals with diabetes should be monitored for development of depression, just as they are monitored for other complications of diabetes. It also suggests that individuals with depression should be monitored for development of type 2 diabetes and behavioral treatments for depression may also need to incorporate management approaches for altering obesity-promoting health behaviors,” stresses Golden.
Ultimately, people with these conditions may have to be their own advocates to get screenings. Both type 2 diabetes and depression are treatable and manageable, and research further suggests that treating depression in people with diabetes may help them manage their diabetes better.
“People with one condition — diabetes or depression — should recognize that they are at increased risk for developing the other and engage in a dialogue with their physicians about addressing and treating the depression that can often accompany the diabetes,” advises Golden.