Glu : Did you know? Depression Related to HbA1c in Type 1, but not Type 2, Diabetes
Factors associated with depression in type 1 and type 2 diabetes were shared with has shown that a relationship exists between depression and diabetes (1). Relationship of Depression to Diabetes Types. 1 and 2: Epidemiology, Biology, and Treatment. Dominique L. Musselman, Ephi Betan, Hannah Larsen, and. Dec 9, However, they found a strong relationship between HbA1c and depressive symptoms in those with type 1 diabetes, but not those with type 2.
It has also been suggested that the mood symptoms secondary to a chronic condition may be strongest just after the initial development of the condition. This risk may be a result of an increase in counterregulatory hormone release and function, alterations in the glucose transport system, and increased immune-inflammatory activation.
These developments then lead to insulin resistance and islet beta-cell dysfunction. This may be due to lifestyle habits associated with depression.
These lifestyle habits may include poor health behaviors such as smoking, high-fat diet, and excessive alcohol intake, all of which contribute to an increased risk of diabetes.
These agents have a high affinity to histamine, acetylcholine, and alpha-adrenoreceptors. Due to the histamine1 antagonism, TCAs are associated with weight gain, which is one of the risk factors of developing type 2 diabetes. MAOIs, such as phenelzine Nardilare classified as either hydrazines or nonhydrazines. One of the most common adverse effects of MAOIs is weight gain, which often leads to the discontinuation of these agents as well as to the development of type 2 diabetes.
These agents were developed in an effort to decrease the number of adverse effects seen with antidepressants.
These agents, such as trazodone Oleptroare inhibitors of 5-HT2 receptors. Examples of these agents are bupropion Wellbutrin and mirtazapine Remeron.
Relationship of depression to diabetes types 1 and 2: epidemiology, biology, and treatment.
Based on their unique structures, these drugs have a different side-effect profile than most antidepressants. Adverse effects such as weight gain are specific to each agent. There are three main phases of treatment for patients diagnosed with MDD: In addition to the pharmacologic treatment of MDD, nonpharmacologic treatment, such as psychotherapy or electroconvulsive therapy, may also play an important role in the overall treatment regimen. The effects of psychotherapy and antidepressant medications are considered to be additive in the overall resolution of depressive symptoms.
Aerobic exercise improves insulin sensitivity and mildly improves glycemic control in the majority of individuals, reduces cardiovascular risk factors, and contributes to weight loss or maintenance, thereby improving well-being. All patients with type 1 diabetes will require exogenous insulin.
Patients with type 2 diabetes are able to take oral agents to help with the production of and sensitization to insulin.
The Correlation Between Depression and Diabetes
Patients may also be initiated on insulin as well to augment treatment. Because of the weight gain associated with some antidepressants, patients experiencing depression are at risk of the development of type 2 diabetes. More emphasis on nonpharmacologic treatment is the main focus for patients with an elevated risk for diabetes, such as a family risk of diabetes, gestational diabetes, or overweight. Bupropion is the least likely to cause weight gain of all the antidepressants.
It has been shown that patients who have achieved control through diet, oral hypoglycemic agents, insulin, or combinations of oral agents with insulin therapy have a better sense of well-being, improving their mood. While there are hypotheses that explain this relationship, the exact pathophysiology remains unclear. It is known that patients with depression are at an increased risk of early death most commonly associated with cardiovascular disease.
It is projected that by the yeardepression will be the second leading contributor to the global burden of disease.
While the lifestyle factors of depressed patients should be considered, if drugs are used to address depressive symptoms, their effect on the risk of diabetes should also be considered. The use of antidepressants for the treatment of depression may contribute to this risk of diabetes; specifically, anti-depressants that are associated with significant weight gain i. An increase in weight is considered to be a risk factor for type 2 diabetes.
When treating a patient with comorbid depression and diabetes, one should consider the use of antidepressants that are known to have less risk of increased weight i. Metabolic syndrome and major depression. American Psychiatric Publishing; Neuroscientific Basis and Practical Applications. Cambridge University Press; An estimated 1 in 10 U.Type 1 vs. Type 2 Diabetes
Accessed June 29, Accessed on June 29, Pathogenesis of type 2 diabetes mellitus: This was one of the first articles to address the idea that combing type 1 and type 2 in psychological research creates confusing results and misinforms the public. Study Methods and Results The researchers in this study recruited 64 people with diabetes about half were type 1 and collected information from them, including HbA1c, how often people self-monitor their own blood glucose, and demographic variables.
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They also assessed depressive symptoms by using a scale called the Beck Depression Inventory. This is a question multiple choice measure3 that asks pretty straightforward questions regarding specific feelings. For example, one item is: In this study, the researchers found that the majority of the participants scored below the cutoff for clinical depression, but many did show depressive symptoms.
There was no difference in depression scores between those with type 1 and those with type 2 diabetes; that is, both groups showed the same amount of depressive symptoms.
Diabetes and Depression: Managing Your Mental Health
However, they found a strong relationship between HbA1c and depressive symptoms in those with type 1 diabetes, but not those with type 2 diabetes.
This was a positive correlation; that is, higher depressive scores were related with higher HbA1c levels. Low levels of depressed mood do seem to have a profound impact. Why is this difference only seen in those with type 1?
I suggest that mood has a greater impact on health-related behavior in those with type 1. Because type 1 diabetes relies so heavily on day-to-day heck, hour-to-hour self-care, it may be that those who are more depressed than others are struggling to manage their disease. Indeed, the study also reports that those who check their blood sugar less often are also more depressed. Alternatively, it could be that feeling sad causes stress, and this stress increases daily blood glucose levels.
But then, we would expect to see the same results in those with type 2. This article really drives home the importance of taking care of yourself, both mentally and physically, and points to a strong mind-body connection. This seems so obvious to me!