Diabetes and Depression

Diabetes mellitus affects about 20% of adults older than 65 years of age and its prevalence among Americans is reaching epidemic proportions. In cross-sectional studies, diabetes mellitus has been associated with various complications and comorbid conditions, especially psychiatric disorders. The relationship between diabetes and depression is particularly complex. Evidence demonstrates high co-occurrence of these disorders, with associated poorer medical outcomes. Studies have also shown an increased risk for Alzheimer’s disease and more rapid cognitive decline for diabetic patients. The neuroanatomic changes that occur in depression, as well as the neurochemical, neuroendocrine, and resultant inflammatory effects that occur in patients with co-occurring depression and diabetes, are reviewed. The range of treatments for depression including pharmacologic and non-pharmacologic is discussed, with particular consideration of impact of these treatments on patients with diabetes and/or cognitive impairment.