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Depression and Diabetes

Depression is about twice as common among people with diabetes than the general population, affecting at least 15% of people with the condition.

While depression in and of itself is a problem if left untreated, depression can also have a negative impact on diabetes self-management, blood sugar control, and the potential for complications. If you are feeling depressed, be sure to tell your health care provider. There are steps you can take to feel better.

The Link Between Diabetes and Depression

Whether or not you have diabetes, there is not just one cause of depression. It is a complex disease that can occur as a result of a multitude of different factors, including biology, emotional, and environmental influences. For people with diabetes, depression can develop as a result of the lifestyle adjustments they have to make to control their diabetes. Managing diabetes can be stressful and time consuming and the dietary restrictions can make life seem less enjoyable.

Symptoms of Depression

There are several warning signs and symptoms of depression, including:

  • Sadness.
  • Anxiety.
  • Irritability.
  • Loss of interest in activities once enjoyed.
  • Withdrawal from social activities.
  • Inability to concentrate.
  • Insomnia (difficulty falling and staying asleep).
  • Excessive feelings of guilt or worthlessness.
  • Loss of energy or fatigue.
  • Changes in appetite.
  • Observable mental and physical sluggishness.
  • Thoughts of death or suicide.

If you (or someone you love) has diabetes and show signs of depression, tell your doctor immediately.

Diagnosing Depression

There are no lab tests to specifically diagnose depression. The diagnosis is based on reported symptoms -- including any problems with functioning caused by the symptoms.

Depression Treatment With Diabetes

Depression in people with diabetes has been successfully treated with tricyclic antidepressants. These drugs work by increasing the levels of norepinephrine and serotonin, neurotransmitters in the brain that help nerve cells communicate with each other. If these chemicals are out of balance or not working properly, messages may not make it through the brain correctly, leading to symptoms of depression. Tricyclic antidepressants work by correcting the balance of these chemicals.

Common tricyclics include Elavil, Norpramin and Pamelor. Another type of antidepressant, called SSRIs, include Prozac, Paxil, Zoloft, and others.

Common side effects of tricyclic antidepressants include:

  • Blurred vision
  • Dry mouth
  • Dizziness
  • Weight gain
  • Constipation
  • Nausea
  • Diarrhea
  • Agitation
  • Insomnia (difficulty falling and staying asleep)
  • Nervousness
  • Headache
  • Changes in sexual desire and/or ability
  • Exhaustion
  • Muscle twitching (tremors)
  • Increased heart rate

Common side effects of SSRI antidepressants include:

  • Nausea
  • Diarrhea
  • Headache
  • Agitation
  • Nervousness
  • Nightmares
  • Dizziness or lightheadedness
  • Changes in sexual desire and/or ability

These side effects of antidepressants often go away or become tolerable over time. To minimize the side effects, your doctor may prescribe a small dose of the medication and gradually build up to a higher dose. Side effects also vary with the specific antidepressant used; not every drug causes all of these side effects. Therefore, it may help to change to a different drug that is less likely to cause a particularly uncomfortable side effect if you are having problems.

Counseling, or psychotherapy, is also often beneficial for those suffering from depression. Meeting with a support group can also help.

The Outlook for Depression With Diabetes

The outlook for people with diabetes and depression who seek treatment is very promising. By working with your doctor or a qualified and experienced mental health care professional, you can regain control of your life.


 

WebMD Medical Reference

Reviewed by John A. Seibel, MD on February 25, 2010

Is This Normal?

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Your level is currently NormalHigh (hyperglycemia).Low (hypoglycemia).

If the level is below 70 and you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

If the level is below 70 and you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Your blood sugar level is slightly high. You should call your health care provider and ask if laboratory tests to check for diabetes are needed. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is currently normal. However, if you are concerned about diabetes speak with your physician. There may be other risk factors that increase your risk for diabetes.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

Your blood sugar level may be high, depending on when you last ate. If you have not eaten for at least 8 hours, your blood sugar should be less than 100. If you've eaten within the last 2 hours, your blood sugar should be less than 140. You should call your health care provider and ask if you need laboratory tests to check for diabetes. If you are pregnant always consult with your health care provider.

Blood sugars consistently above 180 warrant prompt medical attention.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

Your blood sugar level is high. You should call your health care provider and ask if laboratory tests to check for diabetes are needed. If you are pregnant always consult with your health care provider.

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