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Dr. Paul LatimerDiabetes is one of the leading health problems affecting North America today and is rapidly on the rise.

It is also well known that this disease can cause serious health complications such as vision loss and amputation as well as life-threatening problems like stroke, heart disease and kidney failure.

Indeed, diabetes, which affects the body’s ability to process sugar, is becoming one of the four big killers in the western world.

Not as well documented are the mental health implications of diabetes. People with diabetes are at greater risk of developing depression than the rest of the population and some studies actually suggest that diabetes doubles the risk. Depression and diabetes seem to be linked in reverse as well because people who are depressed are more likely to develop diabetes than those who are not depressed.

Also, as diabetic complications worsen, it becomes even more likely that the individual will develop depression. Again, the reverse is true – people with diabetes and a history of depression are more likely to develop diabetic complications than those without depression.

Research shows that the experience of depression leads to poorer physical and mental functioning, which means that a diabetic with depression may be less likely to follow the required diet or medication plan. This can be extremely dangerous.

Treating depression can help to manage the symptoms of both diseases to an extent as well as simply allowing the individual to be motivated and interested in following the necessary regimens for diabetes treatment.

Unfortunately, the causes underlying the association between depression and diabetes are still unclear. Depression may develop as a result of the stress of having a chronic illness, but may also be the result of the metabolic effects of diabetes on the brain. More research is needed to uncover the relationship between the two disorders.

Depression is not the only mental health issue that seems to have some relationship with diabetes.

Diabetes is more common in psychiatric patients in general than in the rest of the population. In fact, type 2 diabetes is thought to be two to four times more prevalent among people with schizophrenia and up to three times more prevalent in those with bipolar disorder.

There is also a link between diabetes and Alzheimer’s Disease. As mentioned in an earlier column about Alzheimer’s, a gene responsible for the insulin degradation enzyme is also important to diabetes. Type 2 diabetics have a two-fold increase in Alzheimer’s prevalence and those with Alzheimer’s have a two-fold increase in the prevalence of diabetes as well.

As with depression, more research is needed in order to understand the relationship between mental health disorders and diabetes.

In young people with type 1 diabetes, there may also be an increased risk of developing an eating disorder. Strict diet requirements and focus on nutritional intake as well as the need for parental control and increased weight gain that insulin treatment can cause may all play a role in the increased risk for anorexia and or bulimia in young diabetics.

Diabetics with co-existing eating disorders are at an increased risk for developing severe vision problems or blindness from their disease.

Stress and anger at having a chronic illness are also common mental health implications to coincide with diabetes. These are also important to manage as stress can raise blood glucose and blood pressure. Getting regular sleep and exercise and ensuring a positive support network can all help to reduce the effects of stress.

Diabetes affects more Canadians each year and two of the primary risk factors for the disease are obesity and lack of exercise. Leading a balanced and healthy lifestyle with plenty of exercise and limiting fatty foods can prevent adult-onset diabetes in most cases.

Dr. Latimer is president of Okanagan Clinical Trials and a Kelowna psychiatrist.

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