Diabetes and Mental Health: A Two-Way Street
Heart attack, stroke, nerve damage – these are just a few of the many complications that millions of Americans with diabetes face on a daily basis. But what many may not realize is that the relationship between diabetes and mental health is a two-way street.
A recent study led by the University of Michigan has shed light on the fact that individuals with diabetes are not only at a higher risk of developing mental health disorders, but those with mental health disorders are also more likely to experience chronic complications of diabetes.
Dr. Brian Callaghan, the senior author of the study, explained, “We wanted to see if chronic diabetes complications led to mental health disorders or if mental health disorders led to those diabetes complications – but we found that both relationships are true.”
The research team examined data from over 500,000 individuals with type 1 or type 2 diabetes and 350,000 people without diabetes. The results, published in Diabetes Care, revealed that individuals with chronic diabetes complications had up to a three-times greater risk of developing a mental health condition, such as anxiety or depression.
Conversely, those with mental health disorders were up to 2.5 times more likely to experience sustained diabetes complications. The relationship between the two conditions seemed to increase with age, with older adults being more at risk.
Dr. Callaghan pointed out, “For instance, a stroke causes detrimental effects on the brain, which may directly lead to depression. And having a mental health condition and diabetes may affect a person’s self-management of their condition – like poor glycemic control or not taking medications – which, in turn, may increase their risk of diabetes complications.”
There are also common risk factors that contribute to the development of both diabetes complications and mental health conditions. Issues such as obesity, poor glycemic control, and other social determinants of health can all increase the likelihood of experiencing these comorbidities.
Maya Watanabe, the first author of the study, emphasized, “Most likely, a combination of direct and indirect effects, and shared risk factors drive the association we are seeing. Diabetes care providers may be able to simultaneously prevent the risk of multiple complications by providing interventions to treat these shared risk factors.”
It is estimated that up to 50% of people with diabetes may experience feelings of distress related to their condition in an 18-month period. While some national diabetes centers have implemented depression and distress screening, there is still no universal screening process for mental health in diabetes care.
The lack of mental health screening and care in diabetes management is a critical issue that needs to be addressed. As Dr. Eva Feldman, the co-author of the study, stated, “These systems should include mental health screening, easily accessible insurance coverage for mental health services, and both physician and patient education programs. Action is needed, and our new research provides further evidence that this action needs to occur now.”
It is clear that the relationship between diabetes and mental health is complex and multi-faceted. By addressing both conditions simultaneously and providing proper screening and care, healthcare providers can better support individuals with diabetes and improve their overall health outcomes.
