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got this off the American Diabetes Assoc webpage....thought someone might
like to read it!

Blood Sugar Blues: The Link Between Diabetes and Depression
Paula Yurtzy's son Will was diagnosed with diabetes when he was 11 years old.
     A few years after his diagnosis, Will began to have trouble dealing with
the disease emotionally-he experienced feelings of fear, self-blame, low
self-esteem, and hopelessness.      Yurtzy, now a certified diabetes nurse
educator in The Diabetes Center at Mercy Medical Center in Baltimore,
understands why. Will was depressed.      "Depression frequently goes with
diabetes, either before or as a result of," she says. "People who have mood
disorders or difficulty in coping with life situations are probably more
likely to become depressed with a diagnosis of diabetes. It is just 'one more
thing' that goes wrong in their lives."      In fact, depression is about two
times more prevalent in people with diabetes than in similar people without
diabetes, according to Greg Nichols, PhD, a senior researcher with Portland,
OR-based Kaiser Permanente Center for Health Research. Nichols presented this
finding and others at the annual meeting of the American Diabetes
Association. And although diabetes sometimes causes feelings of depression-as
in Will Yurtzy's case-recent research shows us that it's the other way
around.      In other words, depression may cause diabetes.      "We've found
that about 75 percent of the time, depression was diagnosed by an average of
four years prior to a diabetes diagnosis," Nichols says. "Does this mean that
depression causes diabetes? You could argue that depression is
immunosuppressive, so in persons predisposed to diabetes, depression could
bring it on."      More likely, Nichols says, depression is a component of
the "insulin resistance syndrome," which is a constellation of diseases
including diabetes, obesity, and cardiovascular disease that are more common
in people less sensitive to the effects of insulin.      In the human
pancreas, beta cells make the hormone insulin. The insulin allows the body to
use or store the glucose it gets from food. But people with diabetes either
don't make insulin, don't make enough or don't respond to it. The result can
be a myriad of problems like the insulin resistance syndrome diseases.
     The concept is similar to the way that chronic fatigue syndrome can
cause a variety of mental, physical and emotional problems, according to Dr.
Patrick Lustman, a researcher at the St. Louis-based Washington University
School of Medicine and considered the foremost authority on the link between
diabetes and depression.      Lustman and his team have spent more than a
decade proving, among other things, that depression has been linked to poor
blood glucose control in patients with diabetes.      "Patients with
depression show worse blood glucose control than patients without
depression," says Mary de Groot, a PhD fellow who works closely with Lustman
at Washington University. "We have also found a moderate association between
depression and diabetes complications. Depression has been found to be
associated with increased number of diabetes complications and greater
severity of complications."      Lustman's team predicts that depression may
occur in as many as 20 percent of people with diabetes.      Since depression
may have negative effects on keeping diabetes under control, all experts
agree that treating the depression as its own separate disorder is just as
important as treating the diabetes.      "I think it's very important to get
the word out that the majority of depression in diabetes is not caused by
receiving the diabetes diagnosis, but in fact precedes the diabetes," Nichols
says, adding that there is a tendency to dismiss the depression as a
temporary effect of the diabetes diagnosis rather than treating it as a very
real disorder.      In addition to the obvious ones, there are several
benefits to treating a diabetic's depression. For instance, Lustman's
research has shown that improving mood can improve glycemic control. Other
studies have shown that people who are depressed are less likely to take
medications, more likely to be obese and less likely to be physically active
than are people who are not depressed. Obesity and inactivity are known risk
factors for diabetes and heart disease.      "A person with diabetes has 99
percent of the responsibility for managing their disease and 100 percent of
the consequences of their decisions," she says. "The risks of untreated
depression in diabetes include the self-destructive risks of anyone with
depression along with the damage uncontrolled diabetes does to the body."
     That's a risk no one should take.      Identifying Depression      So
how do you know if you're a diabetic also suffering from depression? The
symptoms of depression commonly last a period of two weeks or longer, de Root
says, and may include: prolonged sadness or "the blues" lack of interest in
usual activities change in weight or appetite loss of energy disrupted sleep
or more sleep than usual feelings of worthlessness reduced concentration or
attention thoughts of hurting yourself      Anyone experiencing these
symptoms should contact their his/her health care provider(s) to arrange for
counseling and talk about possible medication; doing so may very well reduce
the risk of experiencing complications associated with the diabetes. As
Yurtzy says, diabetes is a disease that must be self-managed.
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