A patient who suffers from a combination of depression, diabetes, and heart disease has a 30 percent higher-than-average death risk, a new study indicates. Researchers from Duke University presented these findings on March 9 at the annual meeting of the American Psychosomatic Society in Budapest.
Duke researchers studied 933 subjects with heart disease over a four-year period. Of these, 135 subjects who also had type 2 diabetes, depression, or both in addition to heart disease died during the course of the study. Subjects with moderate or severe depression, diabetes, and heart disease were 30 percent more likely to die during this period than subjects with heart disease and depression or heart disease and diabetes.
“We do not know what this increased risk is due to, but it could either be that depression influences crucial aspects of self-care behaviors needed to manage diabetes or that a more severe disease process is reflected in more depressive symptoms,” said Anastasia Georgiades, a research associate in the department of psychiatry and behavioral science at Duke University in Durham, North Carolina. Georgiades was the lead author of the study.
The Duke study’s findings indicate that depression and diabetes interact, but researchers can’t tell exactly how.
“The results from the present study will need to be replicated, since they are far from conclusive,” Georgiades said. “Future research will also aim to investigate the mechanisms behind the associations closer. In the meantime, our advice is that physicians monitor these potential high-risk patients carefully.”
According to the American Diabetes Association, prior research shows that patients with diabetes have a higher-than-average risk of developing depression. Complications from diabetes, struggling to maintain blood sugar levels, and a poor doctor-patient relationship are some of the factors that can lead to feelings of frustration, sadness, and isolation, which can then lead to depression.
Once a diabetic patient becomes depressed, a “vicious cycle” sets in. He or she may be less likely to follow through with daily diabetes management, such as blood sugar testing and eating the right foods. The resulting disruption of blood sugar levels exacerbates the symptoms of depression.
Lana Watkins, co-author of the Duke study and an assistant research professor in Duke’s department of psychiatry and behavioral sciences, said that “if you or a loved one has coronary artery disease and diabetes, depression may impact your survival, particularly if it’s severe enough to interfere with your daily activities.”
“Talk to your doctor and check whether you can get help for your depression, either through medicines or through changes in your life, like social activities or exercise,” Watkins added.
American Diabetes Association
Info on depression and diabetes: http://www.diabetes.org/type-2-diabetes/depression.jsp