Reviewed by Michael Fuller, MD
Depression is a common complication of diabetes, estimated to affect diabetics three to four times more frequently than the general population. The combination of diabetes and depression can be dangerous, especially when depression-related behavioral changes lead to poor management of blood sugar and insulin levels.
The American Diabetic Association notes that while roughly three to five percent of the general population suffers from depression at any given time, between fifteen and 20 percent of people with diabetes experience depression.
It is not known if diabetes itself causes depression, or if risk factors that can cause (type 2) or worsen (type 1) diabetes – such as obesity, lack of access to health resources, lack of exercise – may also cause depression. Chickens and eggs aside, what is known is that psychological and behavioral interactions between diabetes and depression can worsen both, and drastically increase health risks.
Research has shown that people with both diabetes and depression are at higher risk for cardiovascular disease, diabetic retinopathy that culminates in blindness, neuropathy (wasting of nerve cells), circulatory disease, and ill health.
Depressed people generally eat more, may crave sweet or starchy foods, and tend to exercise less. These behaviors in combination add up to increased likelihood of type 2 diabetes, and can create dangerous changes in blood sugar levels in those with type 1 diabetes. Depressed adults with diabetes also tend to have significantly higher body mass indices than their non-depressed counterparts. Depression in diabetics has been named a greater risk factor for heart disease than high blood sugar by some research.
In addition, depressed people generally have difficulty completing daily tasks, staying focused, eating and sleeping normally, and may suffer from immune system disturbances and increased vulnerability to infection, all of which are serious liabilities to the health of those with diabetes.