Although we may not always associate these two illnesses together, in reality they are often linked. It turns out that depression is more common in diabetics, and diabetes is more common in depressed people. Patients with Type II Diabetes have a 15-30% greater prevalence of Major Depressive Disorder (MDD) , and patients with MDD have twice the incidence of Type II Diabetes than the general adult population.
Both conditions are common. The prevalence of Type II Diabetes has almost doubled over the past 20 years from 5.5% to 9.3%. This may be at least partly the result of the obesity epidemic in the U. S. The prevalence of MDD is about 9% of the adult population.
Patients with MDD plus anger, anxiety, sadness, or frustration have been shown to have an elevation in their blood sugar. Also, some patients on certain antidepressants may gain weight, which is a risk factor for developing Type II Diabetes. On the other hand, patients with Type II Diabetes and MDD tend to have worse diabetes due to poorer compliance with taking prescribed medication and not following necessary life style practices such as proper diet, regular exercise, and stopping smoking.
Sadly, patients with both conditions have higher average blood glucose levels and more microvascular complications (nerve, kidney and retinal damage) and macrovascular complications (heart attacks and strokes). Also, for unclear reasons there is an increased incidence of dementia in people with both MDD and Type II Diabetes.
The cost of health care also rises when you have both conditions. It is roughly 4.5 times higher than people with only one of them.
As a result of the association of these two illnesses, it is important to monitor patients who have one of them for the development of the other. Treatment of Type II Diabetes does not change much if you also have MDD except that the patient needs greater attention paid to compliance with medications and lifestyle matters.
Patients with both disorders require treatment of both conditions. The depression may be treated with psychotherapy such as Cognitive Behavior Therapy or medications. It may be prudent to use an antidepressant that does not tend to promote weight gain. Patients do better when both conditions are treated.
