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Significantly increased risk of depression in diabetes patients
The risk of developing depression is particularly high for people with diabetes. According to the German Diabetes Society (DDG), diabetics suffer from depression about twice as often as the population on average. "Depression in patients with diabetes is a massive and so far underestimated problem," emphasizes Professor Dr. med. Baptist Gallwitz, past president and spokesman for the DDG.
According to the DDG, an estimated 800,000 of the approximately 6.5 million people in Germany who have diabetes suffer from depression requiring treatment at the same time. This means that “depression is twice as common in people with diabetes as in the general population,” says Professor Dr. Graduate psychologist Bernd Kulzer, spokesman for the Diabetes and Psychology Working Group of the German Diabetes Association (DDG). This can have fatal consequences for those affected.
Diabetes exposure often triggers depression
According to the experts, the diabetes-related stress is often the cause of an accompanying depression. After all, "Patients with diabetes have to take responsibility for their therapy every day, keep a close eye on their blood sugar levels, dose and take medication, process setbacks," explains Prof. Kulzer. This can be particularly stressful and depressive if, in addition to diabetes, "there are other stresses in life, negative experiences such as hypoglycemia or secondary illnesses occur, or people have little support in dealing with diabetes."
Depression with a negative effect on diabetes treatment
According to the DDG, the consequences of clinical depression on the health of diabetes patients can be extremely far-reaching. Diabetes treatment is significantly endangered by the depressed mood slumps. Patients are often no longer able to take the necessary blood glucose tests and inject insulin. As a result, the long-term blood sugar level HbA1c deteriorates. In such cases, it would hardly be possible to successfully treat diabetes without psychotherapeutic treatment.
Increased risk of complications
The depression in diabetes also leads to direct negative physical effects, since in mental illness, the activation of the pituitary-adrenal axis increases inflammatory processes in the large and small blood vessels. "This in turn promotes the development of further complications such as nerves, eyes, feet or kidneys," explains Prof. The complications such as a stroke or heart attack are also largely responsible for doubling the risk of mortality in people with diabetes and depression. The increased suicide rate also plays a role. "Unfortunately, we have to find that the risk of suicide is higher than in depressed people without diabetes," said Prof. Kulzer.
Pay attention to warnings
Diabetics should urgently seek psychological help with appropriate warning signs, according to the DDG. There are special psychologists here, but those affected "can also turn to any resident psychotherapist," explains Dr. Andrea Benecke, board member of the Federal Chamber of Psychotherapists (BPtK). So far, around half of all depression in diabetes has not been recognized, adds Prof. "The diagnosis is made far too rarely," says the expert. The warnings should therefore never be ignored. "If therapy becomes a burden and costs more energy than before, that's an alarm signal," emphasizes Kurz.
Psychotherapy offers help
Affected diabetics can be helped with special psychotherapy, the goal of which is a stable mental state "that enables a return to reliable self-management of diabetes, which in turn is expressed in a stable HbA1c value," said Dr. Andrea Benecke. However, the prerequisite is that the affected person should contact a psychologist or psychotherapist if there are appropriate warning signals. (fp)