Research is providing further evidence of a strong correlation between our physical and mental health. Many studies across recent decades have revealed links between various aspects of our physiological and psychological health. Now, a paper delivered by researchers from the University of Michigan has added diabetes to the list.
The researchers found that those with chronic diabetes complications such as heart attack, stroke and nerve damage are more likely to have a mental health disorder.
Interestingly, they found that the reverse was also true. To be clear, those with mental health issues are not more likely to become diabetic. But if they are diabetic, having those mental health problems increases their risk of complications associated with diabetes.
The original aim of the research was to find out in which direction the correlation flowed. “We wanted to see if chronic diabetes complications led to mental health disorders,” said Dr Brian Callaghan. “Or, if mental health disorders led to those diabetes complications – but we found that both relationships are true,” he said.
Dr Callaghan is the study’s senior author and Professor of Neurology at the University of Michigan Medical School.
How strong is the link between diabetes complications and mental health?
This two-way link is known as a bi-directional relationship, and the study found it was slightly stronger in one direction. Those with mental health disorders were up to 2.5 times more likely to experience sustained diabetes complications.
However, those with chronic diabetes complications had up to a three-times greater risk of having a mental health condition. Common among those conditions were anxiety or depression, and the risk increased as adults got older.
Dr Callaghan speculated that the link in either direction could be the result of direct physiological interactions.
“For instance, a stroke causes detrimental effects on the brain, which may directly lead to depression,” he said. “And having a mental health condition and diabetes may affect a person’s self-management of their condition.” Examples of this included poor glycaemic control or not taking medications, he said. And this “in turn, may increase their risk of diabetes complications”.
A less straightforward link is also possible given diabetes complications and mental health conditions share common risk factors. These include obesity, issues with glycaemic control and social determinants of health. All of these increase the likelihood of developing both comorbidities.
Lead author Maya Watanabe, a biostatistician at the Harvard T.H. Chan School of Public Health, is betting each way. “Most likely, a combination of direct and indirect effects and shared risk factors drive the association we are seeing,” said the former University of Michigan graduate student research assistant.
How can these findings be usefully applied?
Ms Watanabe believes knowledge of the link can help inform the practices of carers. “Diabetes care providers may be able to simultaneously prevent the risk of multiple complications by providing interventions to treat these shared risk factors,” she said.
The study covered a time span from 2001 to 2018 and involved 553,552 individuals. Of those, 44,735 had type 1 diabetes, 152,187 type 2 diabetes, and 356,630 did not have diabetes.
The research concluded that clinicians should actively screen for mental health disorders in patients with diabetes in addition to screening for chronic complications, which is already the recommended standard of care in diabetes.
Do you suffer from diabetes? Have you also had mental health issues? If so, did you consider a link between the two? Let us know via the comments section below.
Also read: Exercise improves mental health – fact or fiction?
Disclaimer: This article contains general information about health issues and is not advice. For health advice, consult your medical practitioner.
