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Severe Depression

Mud Island Dweller

Mud Island Dweller

Well-Known Member
Messages
1,161
Location
Mud island
Type of diabetes
Treatment type
Tablets (oral)
Dislikes
An awful lot.
On behalf of a friend, female and early 60s

l know diabetes can affect depression but my questions concerns depressed enough to go in to hospital not just a bit upset.

Do any of you know effect of heavy anti depression medication on type 1 physiologically and psychologically on type 1s

The person is still on same 2x daily injections for past l think about 2 yrs, they are carb cutting a bit trying to get into it more. Only (up to me pushing) doing a couple of bloods a day....how many do you suggest pre & post each meal and how many more?

Out of control t1 can you have fast descents into depression then fast climb outs.... drs saying no given local drs looking for others who have had similar.

The type1 is thought caused from meds for depression originally and friend is still very overweight. ... and putting on weight still. As a t1 this is confusing, l dont see it being honey moon period after 2+years

Any help and advice please or feel free to message me,

 
Can't help a lot as I don't know whether anti-depressants can cause blood sugar change. I'm slightly surprised by the twice a day injections; normally for T1 it would be more? Are these mixed insulin of a fixed amount? You can't easily carb count with mixed insulins. If depression remains due to poor blood sugar control then a discussion with the DN about a change to Basal/Bolus regime with perhaps 4-5 injections per day would aid blood sugar control BUT a depressed person may not be able to manage a more complex insulin regime so the right answer isn't obvious. I inject typically 4 times a day and may be measure only 2-3 times. That's lower than most people but I'm quite stable and predictable. The fact that the friend is overweight implies too much insulin and eating too many carbs to match?
 
Many thanks l will check out her replys and post in next couple of days.

l think not seen dn for over 18mths but l need to check. l freaked when l found out and she was going to try see dn but another depression bout hit.

l discussed the self inj problem tonight but l wonder if she had that control and a full idea of bloods it may not help her.

Not sure what insulin and amt she is so will find out.

If she was self sorting with her husbands help and had to go into hosp can someone if need go back to 2x day inj?...l am thinking no.
 
As with everything, will have to test and see how the meds effect your friend. For me, I found I was having alot lower numbers and did need to adjust my insulin to lower amounts. my type 1 happened first, depression followed after, though not immediately. During the time I was on basal/bolus my numbers were higher, especially in mornings, which, I think was the main contributer to my depression, and found a pattern in which sustained good periods of mood coincided with better readings. Did the better readings alone influence my mood, honestly dont know, maybe. Would if possible, use a basal/bolus, due to greater flexibility, and.hopefully better readings as said above, and test more often should your friend feel able to swap to this, and, during the change of insulin routine would recommend testing pre meal, 2 hours after, pre bed, and if driving, pre getting in the car. Best wishes to your friend.

Type 1, pumping nova rapid
 
Have more info to pad out request :)

Friend doesn't drive so that's one thing less to worry over.

Insulin is
Nova mix 30
14 units first thing in the morning
15 units at night before eating

Saw dn not long ago told you are fine....normal helpful dn.

Will start lots bloods from first thing to going to bed .suggested codes like a circle round a number if upset a square if happy gave her husband a sheet l set up and use for an at a glance diary.

I wasn't sure do t1 get dawn phenomena or is that just us t2 explained what it was said l would ask.
 
T1s get dawn phenomenon.

Your friend is on an old school regime that needs her to eat fixed amounts of carbs at set times. Does she know how many carbs she is supposed to eat at each meal?

Depression and poor diabetes control affect each other and need to be treated together, ideally, by staff who understand both conditions.

Sent from the Diabetes Forum App
 
Thanks for the updated info. As Spiker says, the current insulin regime may be OK for starters but really needs to change over the coming weeks if it is to provide better control and enable eating more freely which may in itself help with the depression. It is easy for me to comment from afar not knowing all the facts, but if you can get the attention of HCPs who fully understand depression and insulin regimes it will help to agree the best way forward
 
Her other half is reading this as l sent the link last night we discussed it with this evening so will try chat tomorrow over your replies very useful the more info the better armed.

Only diet was standard "well plate" that is spouted nothing else. Prestty much out hospital post dx and not much advice help since. l think the last check up for hba1c was about first since dx about 18mts ago.

Until l started about low carbs they didnt do any real diet other than avoid sugar now wheels are churning.
 
Nope l wondered about t2 Spiker, she collapsed ended up in hospital and was told t1 18 months ago (l was a bit out on 2yrs) that was the first time diabetes of any sort had ever been mentioned, went straight onto injections. l need to double check but think that she was told it was due to the medication for depression.

 
Antidepressants have actually been associated with the development of T2: It's mentioned as a side effect here with a link that discusses it in more detail. http://www.nhs.uk/Conditions/Antidepressant-drugs/Pages/Side-effects.aspx

Whatever type she has, the twice daily biphasic regime that she is using needs a regular diet in terms of timing of meals, of exercise and consistency of carb content .
You cannot simply alter it to accommodate more or less carbohydrates. Both basal and meal time insulin are included in the same injection. If you reduce the carbohydrates and reduce the insulin then there may not be sufficient insulin to act as a basal , glucose levels may rise between meals and overnight. If you don't reduce the insulin then insulin levels may be too high for meals and cause hypoglycaemia. Any changes have to be gradual This leaflet shows how it works and how this type of insulin is adjusted
http://www.nhslanarkshire.org.uk/Se... Adjustment for twice daily mixed insulin.pdf

However, it is really something that she should be discussing with her HCP.
 
If her sugar is all over the place, then Novomix is obviously not working for her. I had similar problem when I was put on Novomix right after diagnosis - my sugar was not even close to normal. The dose was not enough to cover my lunch, so I was getting high after it. My DN suggested upping the dose, but that caused hypos after breakfast. So I had to eat 2 breakfasts to cover for the hypo, and the dose was still not enough to cover my lunch. This causes big swings in BG and I was gaining weight (I was eating too much to cover the morning hypo!). The swings and high BG caused me to feel terrible (both physically and mentally). I was changed to basal-bolus and it works great for me. I was certanly having mood swings - from bad to good when my sugar was swinging like that.

If may be useful to talk to the DN about changing the regime - if your friend agrees to doing 4 injections per day. I wouldn't worry sbout antidepressants effect on the BG - with basal-bolus is easy to simply change the dose as needed to cover for any effect like this.
 
You advice has been and continues to be invaluable on this, nhs help advice as you see is less than appalling.

Food advice never given only how and when to inject.
Aall 3 of us looked blankly at each other over Phoenix comment about set carb/time etc on meals

No drs ever taken interest in depression/diabetes connection. Pauline friend isnt worried about injs. and you confirmed what l thought/understood about glucose and mood swings

Friends are going to chase up an emergency start appointment with the dn and take it from there.

Will keep you updated on outcomes and please keep any advice coming the better armed the better prepared.
 
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