New evidence suggests that people who experience chronic complications from diabetes are at higher risk of developing mental illness.
Similarly, people with mental health issues are at higher risk of experiencing chronic diabetes complications such as stroke, nerve damage and heart attack, the study found.
Experts are now urging clinicians to routinely screen their diabetes patients for mental illness.
Lead author Dr Brian Callahan said: “We wanted to find out whether chronic diabetes complications lead to mental illness or whether mental illness leads to diabetes complications, and we found that both relationships were true.”
“The findings highlight the need for clinicians to proactively screen for mental illness in their diabetic patients, in addition to screening for chronic complications, which is the recommended standard of care for patients with diabetes.”
During the study, the team analyzed insurance claims from more than 500,000 adults with diabetes and more than 350,000 adults without diabetes.
The researchers found that participants with chronic diabetes problems were three times more likely to suffer from anxiety and depression than those without any complications.
Additionally, the study found that adults with diabetes are at increased risk of mental health complications as they age.
Meanwhile, participants with mental illness were 2.5 times more likely to experience serious diabetes complications.
“A possible reason for this bidirectional relationship may be that diabetic complications and psychiatric disorders have a direct effect on the development of other complications,” the authors wrote.
Dr Callahan added: “For example, stroke can have a negative impact on the brain which can directly lead to depression, and having a psychiatric illness together with diabetes can affect your ability to look after yourself, including poor blood sugar control and medication non-adherence, which can increase the risk of diabetes complications.”
Corresponding author Maya Watanabe said: “It's likely a combination of direct and indirect effects and common risk factors that creates the association we're seeing.
“By offering interventions to treat these common risk factors, diabetes care providers may be able to prevent the risk of multiple complications simultaneously.”
According to the U.S. Centers for Disease Control and Prevention, half of people with diabetes will experience distress related to their condition within an 18-month period.
“Primary care providers and endocrinologists are already overworked, so we need to put systems of care in place to provide mental health care when needed,” said co-author Dr. Eva Feldman.
“These systems should include mental health screening, insurance coverage that makes mental health services easily accessible, and education programs for both doctors and patients.”
She concluded: “Action is needed, and our new study provides further evidence that this action needs to be taken now.”
Read the study in the journal Diabetes Care.
