There’s the sheer drag of having diabetes. “It’s a real downer. Diabetes is a lifelong illness. It’s not like getting pneumonia, where after two weeks you’re better,” says Jacob Warman, M.D., chief of endocrinology at the Brooklyn Hospital in New York City. “You have to watch your diet, take medication, check sugars, be on insulin.”
Also, Dr. Hu says, “people who are depressed are more likely to be overweight and obese and we know that being overweight and obesity are the most important risk factors for diabetes.”
Many common antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) are associated with weight gain, according to Dr. Hu.
Also, Dr. Hu says, “those medications may have deleterious effects on insulin resistance and other metabolic risk factors [such as glucose metabolism] but this is an open question.”
There’s likely also a psychosocial component. “People who have diabetes are likely to have chronic stress which is associated with the management of diabetes and diabetes complications and decreased quality of life and impaired mental health,” Dr. Hu says. “In the long-run, this can contribute to an increased risk of depression.”
Stress hormones such as cortisol rise after long struggles with depression and this has been shown to increase insulin resistance, a hallmark of diabetes, Dr. Hu says.
Higher cortisol levels also contribute to abdominal obesity, a major risk factor for type 2 diabetes.
“These two conditions are becoming more and more common. Clinicians and also individuals should pay attention to the coexistence of those two problems,” Dr. Hu says. “I think it’s very important for clinicians to provide psychosocial counseling to diabetes patients and those diagnosed with depression should get more aggressive monitoring of their glucose markers and their diabetes status.”
