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Depression in Type 1 Diabetes

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Depression is associated with inflammatory and autoimmune diseases in many situations. Studies of diabetic patients have reported a wide range of results, from 3.8 to 27.3 percent also experiencing depression.

Researchers at The University of Colorado pointed out that many investigations have not distinguished between type 1 and type 2 diabetes in relation to depression. While both types of diabetes have similar symptoms and require similar lifestyle adjustments, type 1 may be expected to have a significantly greater association with depression. Type 2 is caused by insulin resistance, and is not currently believed to involve inflammation or immune damage. Type 1, on the other hand, is caused by autoimmune damage to the pancreas. The autoimmune process is associated with elevated levels of inflammatory cytokines which are believed to produce depressive symptoms in a variety of conditions.

The Colorado authors reported a remarkable 32.1 percent rate of depression in the type 1 diabetic patients in their study, compared to 16.0 percent in matched control subjects. Their data come from the Coronary Artery Calcification in Type 1 Diabetes (CACTI) Study, in the time frame from 2006 to 2008. The control subjects were recruited from the same community, including spouses, friends, and neighbors of the diabetic patients. This was done to minimize the environmental differences between diabetic patients and non-diabetic controls. The study included 458 diabetic patients and 546 controls. Depression was measured in two ways, by use of anti-depressants and by the the Beck Depression Inventory II (BDI-II) self-report instrument. Scores greater than 14 on the BDI-II and/or current use of anti-depressants was counted as depression.

The authors concluded that their results are higher than previous reports of depression in diabetes for two reasons: 1-other studies included a mixture of type 1 and type 2 diabetes patients, and 2-different studies use different criteria to define depression.

Depression is associated with complications of diabetes, including coronary artery disease. There are several possible explanations for this.

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EmpowHER Guest

This is sort of a 'duh' finding on the part of researchers. Let me ask them this: wouldn't you be depressed if you found out that you had a disorder that couldn't be cured, required painful injections and/or painful pump infusion sets, painful blood testing at least ten times daily and for which there are no generic drugs to treat it (ALL insulin is brand name, thanks to a lack of generic standards for bio drugs and it is VERY expensive). Oh, and wouldn't you be depressed if you found out that having it put you in a class of 'undesireables' when it comes to purchasing health and life insurance? Wouldn't you be depressed if you were dumped by a boyfriend/girlfriend because they 'just can't handle the needles all the time'? There is nothing good about this disorder and coping with it 24/7/365 is daunting. Oh, and of course, you're treated like a five-year-old by your doctors, no matter what age you are. How would you like to be told 'you're a bad diabetic' (like being a bad dog, I guess) if you slip up at all at the incredibly difficult task of trying to mimic the function of an intrernal organ (gee, maybe we should tell people with heart disease that they are 'bad heart patients' if their results aren't 100% perfect!) on a daily basis. I hate having this, I hate everything about it and my life would have been 100% better if I didn't have it - I would have had more choices in life, I wouldn't live in fear of losing my job (and my work-provided insurance, which pays for the insulin that keeps me alive) and I especially wouldn't have to deal with an ignorant public that treats all diabetics as 'sinners who could have prevented their condition if they weren't pie-eating, fat slobs' or tried to convince me that I could cure it if I just changed my diet (I can't do that - and to be honest, I will beat the next person that tells me this to death with my blood-testing meter). I'd be much, much happier without this condition. There, does that explain why Type 1 diabetics are depressed?

January 25, 2011 - 6:00pm
EmpowHER Guest
Anonymous (reply to Anonymous)

I got type 1 about 20 months ago. Oh, speaking about being treated as a 5-year-old by doctors, well, I worked in a medical practice and when I got t1dm, they made a rule that I was the only employee not allowed to be in the building without a doctor present. They made this rule without an exam or any medical records. The practice manager then started asking why I seemed stressed. I don't know? Do you think it's the frequent hypoglycemic episodes I get as I try to juggle a career, a family, a chronic illness, and learn how to administer appropriate doses of insulin at the same time?

Your post just about encapsulates it for me, as far as my feelings and frustrations go. Well done.

January 26, 2011 - 7:19am
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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