NLM Director’s Comments Transcript
Mental Health Impact Diabetes: 08/25/2014

Diabetes poster. You can live with Diabetes if you learn how!

Photo: Courtesy of the National Library of Medicine.

Greetings from the National Library of Medicine and MedlinePlus.gov

Regards to all our listeners!

I'm Rob Logan, Ph.D. senior staff U.S. National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National Library of Medicine.

Here is what's new this week in MedlinePlus.

While distress, depression, and other anxiety disorders undermine the health of diabetes patients, these conditions need to be more frequently diagnosed and treated, finds a viewpoint recently published in the Journal of the American Medical Association.

The viewpoint’s authors note the rate of depression among persons 18 or older with type 1 or 2 diabetes is more than other adults. The authors add (and we quote): ‘Young adults with type 1 diabetes are especially at risk for poor physical and mental health outcomes and premature mortality’ (end of quote).

The authors add recent research suggests a bidirectional relationship may exist between depression and diabetes. They write (and we quote): ‘just as type 2 diabetes increases the risk for onset of major depression, a major depressive disorder signals increased risk for onset of type 2 diabetes’ (end of quote).

Moreover, the authors explain diabetes distress is now recognized as a separate condition, which is more common than depression. The authors find diabetes distress occurs because diabetes care needs constant self-management, which requires complex personal and family tasks without the luxury of vacation days.

The authors note some of these tasks include checking blood glucose levels to adjust the multiple doses of insulin a person with diabetes takes daily as well as constant awareness of food and physical activities that influence blood glucose levels.

The authors write diabetes patients often feel overwhelmed with the regimen needed to stay well and the possibility of serious complications.

The authors note diabetes depression and distress result in poor self-care, occasional non-adherence with clinical instructions, poor glycemic control, more long term complications, a decreased quality of life, increased unemployment, and work disability.

More positively, the authors note recent research suggests a collaborative care model that adds counseling and peer interaction to anti-depression medications is effective in improving depression, glycemic control, and medical cost savings.

In addition to depression or distress, the authors note diabetes patients tend to have generalized anxiety disorder, panic disorder, and posttraumatic stress disorder. In addition, the authors find women with type 1 diabetes have twice the risk of developing eating disorders compared to other female adults.

The authors explain each of these conditions are different than depression and distress and need to be diagnosed and treated differently.

Unfortunately, the authors note only one of every three adults with diabetes-related disorders, anxieties, distress, or depression is diagnosed. However, the authors explain in addition to better treatment programs, there are well-tested scales that help health care providers screen diabetes patients for mental health concerns. The authors add they hope providers will increase their use of diagnostic scales and refer more diabetes patients for mental health counseling and treatment.

The authors conclude (and we quote) “from economic, public health, and humanitarian perspectives, identifying and treating the mental health comorbidities among patients with diabetes should be a priority’ (end of quote).

Meanwhile, a helpful overview of diabetes is provided by the National Institute of Diabetes and Digestive and Kidney Diseases within the ‘start here’ section of MedlinePlus.gov’s diabetes health topic page. The American Diabetes Association provides two helpful websites on anger and stress related to diabetes within the ‘coping’ section of MedlinePlus.gov’s diabetes health topic page. The American Diabetes Association adds a third website about recognizing and handling depression in the ‘related issues’ section of MedlinePlus.gov’s diabetes health topic page.

MedlinePlus.gov’s diabetes health topic page additionally provides links to the latest pertinent journal research articles, which are available in the ‘journal articles’ section. Links to clinical trials that may be occurring in your area are available in the ‘clinical trials’ section. You can sign up to receive updates about diabetes as they become available on MedlinePlus.gov.

To find MedlinePlus.gov’s diabetes health topic page type ‘diabetes’ in the search box on MedlinePlus.gov’s home page, then, click on ‘diabetes (National Library of Medicine).’ NLM also has health topic pages specifically devoted to Type 1 and Type 2 diabetes.

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Please email Dr. Lindberg anytime at: NLMDirector@nlm.nih.gov

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A disclaimer — the information presented in this program should not replace the medical advice of your physician. You should not use this information to diagnose or treat any disease without first consulting with your physician or other health care provider.

It was nice to be with you. I look forward to meeting you here next week.