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. 2014 Aug;37(8):2067-77.
doi: 10.2337/dc13-2134.

NIDDK international conference report on diabetes and depression: current understanding and future directions

Richard I G Holt  1 , Mary de Groot  2 , Irwin Lucki  3 , Christine M Hunter  4 , Norman Sartorius  5 , Sherita H Golden  6
Affiliations

NIDDK international conference report on diabetes and depression: current understanding and future directions

Richard I G Holt et al. Diabetes Care. 2014 Aug.

Abstract

Comorbid diabetes and depression are a major clinical challenge as the outcomes of each condition are worsened by the other. This article is based on the presentations and discussions during an international meeting on diabetes and depression convened by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) in collaboration with the National Institute of Mental Health and the Dialogue on Diabetes and Depression. While the psychological burden of diabetes may contribute to depression in some cases, this explanation does not sufficiently explain the relationship between these two conditions. Shared biological and behavioral mechanisms, such as hypothalamic-pituitary-adrenal axis activation, inflammation, autonomic dysfunction, sleep disturbance, inactive lifestyle, poor dietary habits, and environmental and cultural risk factors, are important to consider in understanding the link between depression and diabetes. Both individual psychological and pharmacological depression treatments are effective in people with diabetes, but the current range of treatment options is limited and has shown mixed effects on glycemic outcomes. More research is needed to understand what factors contribute to individual differences in vulnerability, treatment response, and resilience to depression and metabolic disorders across the life course and how best to provide care for people with comorbid diabetes and depression in different health care settings. Training programs are needed to create a cross-disciplinary workforce that can work in different models of care for comorbid conditions.

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Figures

Figure 1
Figure 1
Summary of shared pathogenic mechanisms in the depression–diabetes association covered at the International Conference on Depression and Diabetes.
See this image and copyright information in PMC

References

    1. Holt RI, Katon WJ. Dialogue on Diabetes and Depression: Dealing with the double burden of co-morbidity. J Affect Disord 2012;142(Suppl.):S1–S3 - PubMed
    1. Sartorius N, Cimino L. The Dialogue on Diabetes and Depression (DDD): Origins and achievements. J Affect Disord 2012;142(Suppl.):S4–S7 - PubMed
    1. NIH/NIDDK International Conference on Diabetes and Depression. Available from http://www2.niddk.nih.gov/News/Calendar/DiabetesDepression12.htm Accessed 19 September 2012
    1. Fisher EB, Chan JC, Nan H, Sartorius N, Oldenburg B. Co-occurrence of diabetes and depression: conceptual considerations for an emerging global health challenge. J Affect Disord 2012;142(Suppl.):S56–S66 - PubMed
    1. Anderson RJ, Freedland KE, Clouse RE, Lustman PJ. The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care 2001;24:1069–1078 - PubMed

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