TEMPO.CO, Jakarta – Patient diabetes mellitus Type 2 has a two to three times higher risk of developing depression. One of the most common pathophysiological causes is stress and inflammation in the body.
“Diabetes is a mood disorder that combines several symptoms that change the functioning of individuals and interfere with emotions, cognition and behavior,” as it was announced by the American Psychiatric Association in the Journal of Medicine and Life, Tuesday 19 November 2024.
According to the American Psychiatric Association, the diagnostic criteria for major depressive disorder present in a patient type 2 diabetes consists of core symptoms, either low mood, irritability or decreased interest. In addition, there are several symptoms such as feelings of guilt or worthlessness, fatigue or loss of energy, concentration problems, suicidal thoughts or thoughts of death. There are also thoughts of weight loss or weight gain, changes in activity such as always feeling sleepy or not being able to sleep at all that last at least two weeks.
“Prevalence of depression increased moderately in prediabetes patients and in undiagnosed diabetes patients, and increased significantly in previously diagnosed diabetes patients,” wrote Carol Davila , endocrinologist and researcher at the University of Medicine and Pharmacy, Bucharest, Romania.
Anxiety occurs in 40 percent of patients with diabetes type 1 or 2. The effects of depression and anxiety in diabetes mellitus patients can worsen the prognosis of diabetes, increase non-compliance with medical treatment which can reduce the quality of life of diabetes mellitus patients.
One important factor that promotes the symptoms of type 2 diabetes mellitus and depression is environmental or epigenetic factors, namely low socioeconomic status. Other common causes of type 2 diabetes mellitus and depression are lack of sleep, lack of physical exercise, and diet. Taking these factors into account, a prime candidate for a common cause could be the activation and disruption of the stress system that activates the axes of the hypothalamic nervous system, pituitary, adrenal and sympathetic.
“In diabetes mellitus patients, the production of cortisol increases, especially in the adrenal cortex, and the production of adrenaline and noradrenaline increases in the adrenal medulla,” wrote Davila.
2024-11-19 15:24:00
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In what ways might addressing inflammation in Type 2 diabetes patients improve their mental health outcomes?
Question 1: Based on the article, major depressive disorder is more prevalent in Type 2 diabetes patients than in the general population. Could you please describe the possible reasons behind this phenomenon?
Guest 1: Certainly, there are several factors that could contribute to this higher risk of depression in Type 2 diabetes patients. Firstly, diabetes itself can lead to a range of physical and emotional challenges that can affect an individual’s mood and overall wellbeing. For instance, the constant management and monitoring of blood sugar levels, along with potential complications like nerve damage and impaired vision, can be overwhelming and cause significant stress and anxiety. Additionally, living with a chronic condition like diabetes can lead to social isolation, stigma, and feelings of helplessness, which can also increase the risk of depression.
Guest 2: I would also add that the lifestyle changes required to manage Type 2 diabetes, such as dietary modifications and increased physical activity, can be difficult to implement and maintain, especially without appropriate support or motivation. This struggle can lead to feelings of frustration and low self-esteem, which can escalate into depression. Moreover, patients may experience symptoms like fatigue, weight gain, and joint pain, which can further impact their quality of life and contribute to mood disorders.
Question 2: The article cites several studies that suggest a strong correlation between inflammation and depression in patients with Type 2 diabetes. Could you explain how these two factors might be related, and what implications this has for treatment?
Guest 1: Inflammation is now recognized as a significant factor in many chronic diseases, including depression. In the case of Type 2 diabetes, inflammation can lead to insulin resistance, making it harder for the body to regulate blood sugar levels. This inflammatory response may also contribute to the development of depressive symptoms by impacting neurotransmitters like serotonin and dopamine, which play a key role in mood regulation. By addressing both inflammation and depression simultaneously, we might be able to improve overall outcomes for patients with Type 2 diabetes.
Guest 2:
