Diabetes plus depression may equal better blood sugar control

They say that two wrongs do not make a right, but a new study suggests that people who have diabetes and depression may be better able to monitor their blood sugar levels and keep them under control. According to previous research, diabetics are more susceptible to stress and depression than other people, which can in turn lead to perilous levels of blood sugar. On the other hand, though, the current study found that taking antidepressants was related to 95% increased chances of properly controlling their blood sugar. “We don’t know the mechanism by which the use of antidepressants is associated with better blood sugars in those patients with both conditions,” lead study author Dr. Jay Brieler of Saint Louis University School of Medicine said. “Regardless of the mechanism, I think that our study adds to the evidence that it is important to properly diagnose and treat depression in diabetics.”

In an email to Reuters, Brieler theorized that people may be more likely to adhere to healthy diet, exercise, check blood sugar, and comply with their diabetes medication prescription once their depression has improved. Researchers are looking as well into the possible physiologic link between the two conditions, and whether shifts in stress hormones brought on by use of antidepressants might affect blood sugars. “From my experience, getting depression under control by whatever means can help people overcome their inertia that prevents them from making their best efforts to deal with their diabetes,” researcher at the University of Cincinnati College of Medicine and the Cincinnati VA Medical Center Dr. Robert Cohen – who wasn’t involved in the study – said.

The study examined the electronic medical records for approximately 1,400 people with diabetes from 2008 to 2013. The records included laboratory tests for blood sugar and prescription information on antidepressant use. The patients were 62 years old on average, most were overweight, and all had type 2 diabetes. Additionally, 225 were being treated for depression, and 40 were diagnosed with depression but were not taking drugs to treat it. Brieler and colleagues estimated the average levels of blood sugar during the span of several months by measuring hemoglobin percentages. Forty-four percent of the patients had their blood sugar under control; 51% of individuals undergoing treatment for depression also had their blood sugar under control, versus 35% of people whose depression was untreated.

The research was limited by the fact that it couldn’t be determined if treating depression resulted in improved blood sugar control, or if reducing blood sugar relieves the symptoms of depression, though neither possibility can be ruled out. Moreover, some antidepressants and antipsychotics can be linked to weight gain and ineffective blood sugar control, which is “why it is important to have those medications prescribed by a health care provider who will be following along closely enough to detect that and determine when changes are needed,” Cohen said in an email.

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