According to the World Health Organization (WHO), around 422 million people across the globe are living with diabetes.
Unfortunately, the UAE has one of the world’s highest rates, with Cleveland Clinic Abu Dhabi estimating that one in five adults has some form of the disease, and that cases will double by 2040. A long-term condition that affects the body’s ability to produce insulin and remove glucose from the bloodstream, diabetes can lead to heart disease, organ failure and other very serious health problems.
Around 90 percent of diagnoses are type two (where the body is unable to use insulin properly), while the the remainder is type one (where the body stops producing insulin altogether).
The correlation between mental and physical health
While the physical effects of diabetes are well-documented, the connection with mental health issues is less discussed.
Dr Rasha Abbas, psychiatry consultant at HealthPlus Diabetes & Endocrinology Center in Abu Dhabi, explains that people with diabetes are almost 20 percent more likely to suffer from depression.
“It all comes down to the close connection between our physical and mental health,” she begins.
“Research proves that poor mental health can lead to poor physical health, and vice versa. So, it’s the same for depression and diabetes. They can negatively impact one another, and positively.”
While depression isn’t a direct symptom of diabetes, the stress that comes with a diagnosis can cause it to develop.
Dr Abbas says: “The majority of patients initially feel stressed, shocked and upset, and that’s a totally normal reaction to finding out that you have any kind of chronic problem.
“After a few weeks, most accept the diagnosis and start concentrating on managing it as best they can. But others will end up feeling so down that they start suffering from depression or anxiety.”
The effects can be seen the other way around, too. While obesity, unhealthy diets and sedentary lifestyles are known to be some of the reasons behind the rise in diabetes cases, she notes that people with depression are particularly at risk as well.
“Depression causes higher levels of stress hormones, and these can affect insulin levels. It can also reduce motivation to eat healthy, exercise and socialize, so there are biological and behavioral reasons why it can encourage the onset of diabetes,” she adds.
Ongoing research
She points out that experts are still studying whether either type of diabetes is more prone to mental health problems: “Some papers suggest that insulin resistance increases the risk of depression, but the reasons for that still aren’t clear and the difference is only small.
“The important thing to remember is that regardless of what type of diabetes, when it was diagnosed, or how controlled it is, people with diabetes are just more prone to developing depression.”
Worryingly, the detection rate of depression in diabetic patients is very low. Around 45 percent of cases go undetected and untreated, which leaves both conditions free to get continually worse.
“Depression negatively impacts diabetic control because it makes people less likely to attend appointments, measure their blood sugars and make efforts to improve their diet and lifestyle,” continues Dr Abbas.
“On the other hand, improving someone’s mood automatically reduces their levels of stress hormones, boosts their metabolism, and increases their response to diabetic treatment. So, it’s vital that they are treated together.”
Simultaneous treatment
To combat both conditions in tandem, a psychiatrist and an endocrinologist (a specialist in hormone-related diseases) will work together to create an integrated model of care.
This always includes some form of counseling or psychological therapies and, depending on the severity, sometimes antidepressants as well.
Dr Abbas believes that in order to properly address the rise of diabetes and depression, society needs to change its outlook as a whole.
“We need to change the mindset of communities and make them see why a healthy lifestyle is so vital for physical and mental health,” she says.
“At the moment, the biggest barriers that are stopping more people from seeking treatment is lack of awareness and the stigma that still surrounds mental health issues. It’s vital we make it clear that having diabetes and depression is not unusual, and that support is easily accessible.”
Symptoms of depression
To be technically diagnosed as depressed you have to feel down, or have a loss of interest in things, for a period of two weeks or more and to the extent that it prevents you from functioning.
Other symptoms are an increase or decrease in appetite, disturbed sleep, concentration problems and persistent negative thoughts about yourself.
Dr Abbas recommends that anyone experiencing the above should speak to their family doctor as soon as possible.
For more information about diabetes and the campaign surrounding World Diabetes Day 2022, please visit worlddiabetesday.org.
