Depression Worsens Outcome In Diabetes

A diabetic person's emotional state may affect the progression of complications of the disease, suggests a new analysis of 27 studies that link depression to various diabetes complications.

Previous studies have shown that depression has an impact on the ability of a person with diabetes to control blood sugar, while other studies show that poor control of blood sugar levels leads to more severe complications.

This analysis bridges the gap, showing that the relationship between depression and diabetes complications is both significant and consistent, says lead author Mary de Groot, Ph.D., of Washington University School of Medicine.

"Increased depression was associated with increased numbers, severity and ratings of diabetes complications," says de Groot.

The study is published in the July issue of Psychosomatic Medicine.

De Groot and her colleagues looked at studies that characterized common complications from diabetes, including nerve damage such as retinopathy, which can lead to blindness, and neuropathy, which can cause a loss of sensation in the limbs. They also assessed the presence and severity of kidney damage, sexual dysfunction and heart disease.

Assessment of the complex relationship between depression and diabetes is difficult in light of the knowledge that a diabetes diagnosis can increase the risk of depression.

"It would be reasonable to speculate that underlying mechanisms linking depression and diabetes complications are a function of biological, social and psychological variables that may interact with depression in differing ways," says de Groot.

People with diabetes should talk with their health providers about all aspects of their well-being, including emotional health, she says.

The study was paid for with funding from the National Heart, Lung and Blood Institute and the National Institute of Diabetes and Digestive and Kidney Diseases.

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Psychosomatic Medicine is the official bimonthly peer-reviewed journal of the American Psychosomatic Society. For information about the journal, contact Joel E. Dimsdale, MD, at (619) 543-5468. For copies of the article, contact the Center for the Advancement of Health at 202.387.2829 or e-mail press@cfah.org.