Diabetes and depression: examining the link
Diabetes is a relentless disease, with chronic health effects for its sufferers. But it’s not just in the body that this disease manifests. Diabetes sufferers are also subject to significant mental strain due to the overwhelming number of parameters they have to control to keep their disease in check, plus the constant worry about possible long-term complications.
This is referred to as ‘Diabetes Distress’.
The Australian Institute of Health and Welfare says that 41.6% of adult Australians who suffer from diabetes also suffer from varying levels of stress and anxiety. Its research revealed that adults with diabetes had a significantly higher prevalence of medium, high or very high psychological distress than those without diabetes (43.4% and 32.2% respectively).
Let’s look at the link between diabetes and depression, and how new diabetes treatment options could also give sufferers some relief from the associated mental health issues.
Intertwined issues with a huge cost
Because diabetes and mental health issues are both so complex, it’s difficult to draw a simple association between them. However, they are inextricably linked.
“Every minute of every day, a person with diabetes faces decisions, thoughts, worries and fears about their diabetes and the future impact the condition may have on their health.
The daily burden of living with diabetes can be significant. It’s estimated that people with diabetes face up to 180 diabetes-related decisions every day. That’s more than 65,000 extra decisions a year.
Distress, anxiety and burnout are real complications of diabetes.”
We already know that Diabetes is Australia’s largest disease burden. Type 2 diabetes costs Australia’s health system $6 billion per year, while Type 1 costs the nation $570 million. Figures from the Australian Government suggest we’re also spending around $10.6 billion per year on mental health-related services.
Could we minimize both of these expenditures - and keep people happier and healthier - by looking at how we treat diabetes?
Diabetes and depression: investigating the link
Many studies (and lots of anecdotal evidence) link chronic conditions like diabetes to depression and anxiety due to the hardship involved in the day-to-day management of the condition: fear of developing complications like cardiac failure, stress relating to the increasing cost of medication and the constant pressure of watching every meal to keep Hba1C levels under control, just to name a few.
These mental health issues, in turn, reduce a patient’s ability to manage their condition effectively. It’s a vicious cycle which can have devastating effects on families and communities.
Community and society also play a vital part in helping (or hindering) the management of diabetes and/or mental health issues. People with lower socioeconomic means may struggle to access:
Comfortable occupations and healthy work environments;
Green space to walk and exercise;
Healthy and plentiful food;
Affordable, good-quality health care;
And social cohesion, capital and support;
All of which are strongly associated with elevated psychological distress, and are associated with increased chances of developing chronic conditions like diabetes. This study reveals:
Among the poorest one-fifth of Australians, 1 in 4 people have psychological distress at a high/very-high level; this compares to about 1 in 20 people in the richest one-fifth of Australians.
Another recent study compared the amount of diabetes sufferers in an area with the amount of green spaces (like parks) close by. The results found that neighbourhoods with less green space were almost twice as likely to contain diabetics:
“Neighbourhood greenspace was inversely associated with screen-detected type 2 diabetes, with 11% prevalence of undiagnosed type 2 diabetes in the lowest quartile of greenspace compared with 6% prevalence in the highest quartile of greenspace.”
(See more statistics like this in our latest infographic: Diabetes: Causes, costs and treatments.)
Faced with many mitigating factors beyond their control, diabetes patients need a better way to manage their condition - in a way that empowers them and boosts their mental health.
How can we help patients better manage diabetes and depression?
Providers of managed care remote monitoring platforms like CareMonitor for Diabetes could help ease the burden on those suffering mental health issues by providing specialised programs which can help them gain control of their diabetes management.
From a study which investigated the effects of an 8-week diabetes behavioral telehealth program:
"Depression is prevalent among individuals with diabetes and associated with suboptimal self-management.
This study documented significant decreases in depression, anxiety, stress, and glucose levels, as well as increased frequency of glucose self-testing, among participants in a diabetes behavioral telehealth program."
CareMonitor’s proprietary diabetes platform allows patients to be part of their own care journey. The platform’s disease management algorithm automatically presents the patient with dynamic, personalised advice to help them meet their individual HbA1c targets based on their age, gender, lifestyle factors and live clinical data.
It’s an empowering new way of treating diabetes; and we hope it’s the beginning of a new conversation around how we can also tackle the associated mental health cost.
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Do you have patients with diabetes who are also suffering from mental health issues? CareMonitor helps you deliver individualised diabetes care remotely and at scale with mental health assessment tools and the ability to customise care teams.
CareMonitor’s proprietary algorithm delivers contextualised messaging to patients to help them meet their diabetes targets based on their age, gender, lifestyle factors and HbA1c levels.
We’re giving hospitals, endocrinologists, epidemiologists, diabetes nurses & educators, GPs and healthcare professionals a new way to manage diabetes pathways and give each patient the individual care they need and deserve.