If depression is called a “cold of the mind,” this “cold” can be a fatal blow for people with diabetes. Recent studies show that the prevalence of depressive symptoms in patients with type 2 diabetes is 3–5 times higher than in the general population, and the recurrence rate of depression is 8 times higher than in non‑diabetic individuals.64% of people with diabetes experienced at least one depressive episode in the past year.Depression in diabetic patients impairs blood glucose control and can even lead to tragic outcomes.
What causes the higher incidence of depression in people with diabetes?
First, diabetes is a long‑term chronic disease with no complete cure. Patients must constantly manage their diet, frequently monitor blood glucose, take medications long‑term, and some require lifelong insulin injections. All these severely reduce quality of life. Some patients believe insulin use indicates severe disease, leading to greater psychological stress and deeper pessimism.
Second, poor blood glucose control may lead to complications within 5–10 years, a constant threat that naturally causes fear, pessimism, and anxiety.
Third, long‑term treatment generates substantial medical costs, placing a heavy financial burden on patients and their families and sharply increasing psychological pressure.When depression occurs in diabetic patients, cortisol secretion becomes excessive. High levels of cortisol reduce glucose utilization, antagonize insulin, raise blood glucose, and create a vicious cycle.
Research by Chinese scholars shows that the incidence of diabetes‑related depression is closely associated with gender, age, disease duration, HbA1c, and complications.
Women have greater emotional fluctuations and a higher risk of depression than men.Middle‑aged people bear pressure from family, society, and daily life, so their prevalence is higher than other age groups.Similarly, patients with longer diabetes duration and more complications face greater mental and financial strain, resulting in a higher depression rate.
Therefore, to improve quality of life for people with diabetes, women, those with long disease duration, multiple complications, and persistently poor blood glucose control should be carefully screened for mental disorders such as depression and receive timely treatment.
Clinical manifestations of diabetes complicated by depression mainly include low mood, ranging from mild sadness to profound grief or even stupor.Some cases present with prominent anxiety and agitation; severe cases may develop psychiatric symptoms such as hallucinations and delusions.Some elderly patients suffer severe insomnia, constipation, abdominal distension, loss of appetite, increased heart rate, elevated blood pressure, and precordial pain.They may also have pain‑dominant symptoms such as headache, backache, and joint pain that do not respond to painkillers.
Family members and doctors should be alert to the onset of diabetes‑related depression when patients show the above conditions.