Depression and Diabetes

Written by Bonnie Sanders Polin PhD

February is National Heart Awareness Month. Please make sure you know the symptoms of heart attacks, and talk your healthcare team about your cholesterol and lipid profiles. If you're not already, make this the year to become heart healthy.

Caloric and Sodium Intake's Impact on Diabetic Retinopathy
This headline gives credence to our mantra: "Take control of your diabetes; don't let it control you." When I see the ophthalmologist each year, I hold my breath as I wait to hear if I'm developing diabetic retinopathy or macular edema. Diabetic retinopathy is a long-term complication of diabetes that can result in blindness. Macular edema, which also negatively impacts vision, is caused by inflammation in the retina. I know that for diabetics, these diseases can cause major problems.

The January 2010 issue of The Archives of Ophthalmology had an article titled "High caloric and sodium intakes as risk factors for progression of retinopathy in type 1 diabetes mellitus" by Monique S. Roy, MD and Malvin N. Janal, PhD. This study determined whether caloric and sodium intake affected diabetic retinopathy risk in 725 African-American patients with diabetes over a 6-year period of time.

Participants completed a questionnaire at the beginning of the study to estimate daily food intake. At the end of the 6 years, the participants were given an eye exam, blood and urine tests, and a structured interview.

There were 469 patients who were found to be at risk for progression of retinopathy. When their baseline questionnaires were examined, they were found to have high caloric intakes that were associated with the 6-year follow-up of retinopathy that threatened their eye sight. High levels of sodium were a risk factor for the development of macular edema, and both high caloric intake and sodium intake were associated with retinopathy.

If you are not sure what you should be eating and how much you should be eating, please sit down with your physician. He or she can refer you to a certified diabetes educator, group classes, and/or a nutritionist.

You may read more about these findings here.

Diabetes and Depression
The February 2010 issue of Diabetes Care included an article titled "Depression and advanced complications of diabetes" by Elizabeth H.B. Lin, MD, MPH et al. It's a very interesting article because it attempts to associate macrovascular disease (a disease of the larger blood vessels, such as coronary disease) and microvascular disease (a disease of the smaller blood vessels, such as neuropathy) with severe depression in patients with type 2 diabetes.

This study examined the records of 4,623 patients who had advanced microvascular diseases of blindness, end-stage kidney disease, amputations, and renal failure deaths. Some subjects also had macrovascular diseases, including heart attacks and strokes.

The researchers reported that major depression raised the risk of both microvascular and macrovascular diseases over a period of 5 years.

These results will need to be replicated in another study. But in the meantime, if you or someone you love has depression, do not hesitate to talk to a medical professional about it. Depression is a serious disorder, and you should seek proper treatment as soon as possible.

Read more about this study here.