Diabetes and Depression

Depression must be managed adequately because this disorder may affect one’s decision making; memory and ability to self-manage. A person with depression may be unable to function effectively at work or at home and therefore may not be able to handle basic self management such as:

  • following diet and exercise routines,
  • performing home blood glucose monitoring,
  • refilling prescriptions,
  • visits to diabetes physician
  • taking medications as prescribed,
  • maintaining other healthy habits such as not smoking or drinking excessive alcohol.

Major depression and other such illnesses also increase the risk of diabetes because of the link between emotional stressors and hyperglycaemia.

Persons with depression should be screened for diabetes and persons with diabetes should be screened for depression.

Twice as many women as men may be depressed, but men have a greater likelihood of mortality. Research has shown that depression is linked to early death in persons over age 65 with diabetes.

50% of adolescents with both Type 1 and Type 2 diabetes may have emotional challenges that result in depression or anxiety and we need to be vigilant so that we can assist these younger patients. Likewise, older persons may experience complications or disability and may incur greater expense with treatment; these factors may increase depressive symptoms and discouragement.

After medical treatment of depression and improvement of quality of life and symptoms, further intervention is necessary to improve glucose control and weight loss, however the underlying illness must be the focus of initial treatment.

The good news about diabetes is that although it is a chronic illness, the incidence of complications is decreasing due to ever advancing intensive treatment options.

Stay positive.

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Diabetes and Alcohol

There are often questions about alcohol use when you have diabetes. Alcohol intake is not encouraged for the following reasons:

  • Alcohol use may result in hypoglycaemia especially if you use insulin or drink alcohol without eating food.
  • Alcohol can increase triglyceride levels, leading to hyperlipidemia.
  • Alcohol may impair your ability to recognise hypoglycaemia and may cause unhealthy eating behaviours due to impaired judgement.
  • Alcohol adds empty calories that are caloric intake devoid of nutritional value, causing weight gain particularly around the abdomen.
  • You should avoid alcohol if you have addiction tendencies, pancreatitis, problems with your cholesterol or triglycerides or nerve damage.
  • You should avoid alcohol if you are starting a program for getting your blood glucose controlled.
  • If you are known to drink alcohol this could be a concern because others may mistake an episode of hypoglycaemia for alcohol intoxication.

If your blood glucose is under control (and has been for more than one year) and you have no complications, and you choose to drink alcohol:

  • Check your blood glucose before and after drinking alcohol.
  • Have the alcohol with food to slow the absorption of the alcohol.
  • Do not drink in excess (12oz beer, 5oz wine, 1 ½ ounces liquor)
  • Do not drink when you are alone
  • Have glucose tablets or gel on hand for to treat hypoglycaemia.
  • Do not add exercise to alcohol use.

Alcohol intake is not recommended when your blood glucose is not well controlled.

The recommendation is no more than two drinks for men and no more than one for women per day.
However, in a recent study, drinking alcohol more than twice a week was found to increase the risk of death from stroke. Diabetes also increases the risk of stroke. See Diabetes News

Talk to your diabetes physician about what is safe for you.