Diabetes and depression often go together: study By Amy Norton May 24, 2001 - NEW YORK (Reuters Health) - For many people, diabetes and depression may go hand-in-hand, according to an analysis of 25 years of data on the link between the two conditions. People with diabetes are twice as likely as non-diabetics to suffer from depression, researchers report in the June issue of Diabetes Care. But whether the diabetes precedes the onset of depression or vice-versa depends upon the individual, according to Dr. Patrick Lustman of Washington University School of Medicine and the Department of Veterans Affairs Medical Center in St. Louis, Missouri. The relationship between depression and diabetes has been noted for years, Lustman said in an interview with Reuters Health. He and his colleagues reviewed 42 studies on the link in order to more firmly establish how often the two illnesses occur together. Many people may believe depression is just part of having a chronic illness, but this is a "simplistic view," Lustman said. Instead, he explained, depression is a separate illness that frequently "co-occurs" with diabetes, and some research suggests depression often precedes and helps triggers the onset of diabetes. For example, depression-related behaviors such as overeating and getting little exercise are also key to the development of type 2 diabetes-the form of the disease that is closely linked to obesity. In addition, Lustman said, diabetes and depression affect some of the same hormones and neurotransmitters. For example, he explained, depression can promote resistance to insulin, a hormone that regulates blood sugar. Insulin resistance is a precursor to type 2 diabetes. But whenever and however depression arises, Lustman noted, getting it treated is what is important. "You have to tell your doctor about it, and get treatment for both conditions," he said. The importance of this, according to Lustman, has been made clear in research showing that depressed diabetics have poorer control over their blood sugar and higher rates of diabetes complications including heart and kidney disease. But there is also "good evidence" that fighting the depression might prevent these diabetes complications, Lustman pointed out. "The good news," he said, "is that treatment of the mood problem improves not only mood, but [blood sugar] control." SOURCE: Diabetes Care 2001;24:1069-1078.