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 Researchers have known that people with diabetes have a higher rate
of depression than those without the blood sugar disorder. And
people with both conditions tend to do worse over the long run than
people with diabetes but no depression.
Inflammation is a sign of the body responding to disease, trauma or
other stressors. The new study suggests higher inflammation levels
may help explain the link between diabetes, depression and worse
overall health, researchers said. But it’s still not clear how,
exactly.
“We asked, why is depression so bad for diabetes? The study suggests
that we have a possible biological explanation,” Dr. Khalida Ismail
told Reuters Health.
“Inflammation may be driving a number of different long-term
conditions. That’s quite a new way of thinking of the mind and the
body,” she said.
Ismail worked on the study at the Institute of Psychiatry at King’s
College London in the UK.
She and her colleagues examined 1,227 people with newly diagnosed
type 2 diabetes.
Those who reported symptoms of depression tended to be younger and
heavier. They also had higher rates of heart and circulation
problems and higher concentrations of established markers of
inflammation in their blood, according to results published in
Diabetes Care.
After the researchers took into account other potential differences
between study participants, such as their age, sex, amount of body
fat and use of certain medications, six of the 12 inflammatory
markers they measured were still linked to depression.
More than one in 20 Americans reported depression in 2005-2006, and
about one in 12 has diabetes, a major cause of heart disease and
stroke, according to the Centers for Disease Control and Prevention.
Death rates are up to twice as high among people with depression and
diabetes as those with diabetes alone, Ismail said.
“The conventional wisdom is that this is a consequence of the
psychological burden of having diabetes,” she said. “If that’s the
case, if you treat the depression, the diabetes control should
improve.”
But it does not, Ismail said. So she began to wonder if
inflammation, often seen in people with diabetes, could help explain
both conditions and the worse outcomes.
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“It’s a bit like an engine,” Ismail said. “You’re running a bit
higher. So there’s this constant low-grade inflammation and that’s
causing damage to your brain, your pancreas and to your vascular
system.”
Dr. Anne Peters said she often sees patients with diabetes,
depression and elevated markers for inflammation. But there are
still many questions about how they are related.
“The development of depression could in part be triggered by
inflammation, but we don’t know what comes first,” she told Reuters
Health. “This paper can’t prove causality. The interplay is so
complicated.”
Peters directs the University of Southern California Clinical
Diabetes Program in Beverly Hills and was not involved in the
current study.
“To me, it’s as much a part of diabetes care as looking at blood
sugars to screen for and treat depression,” she said.
She believes the best way to begin to combat both depression and
diabetes is to eat well and exercise. Her own study found that
depression scores among people with diabetes dropped when they were
physically active.
“If you exercise, you feel better, your inflammatory markers
improve. It’s all about lifestyle interplaying with your health.
We’re just living lives we were not made to live. We sit still too
much at work. We’re caged up in a way,” she said.
Peters cited a 2012 study that found that people taking
antidepressants were at higher risk for diabetes than
non-antidepressant users, even after taking their weight into
account. The current study did not examine antidepressant use.
SOURCE: http://bit.ly/1l3jaAj Diabetes Care, online May 19, 2014.
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