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.