Major depression is linked to severe hypoglycemia, according to new research.
The study, which was published in BMJ Open Research and Diabetes Care, suggests that clinicians should be aware that poor mental health is often associated with poor glycemic control.
The researchers examined the data of 4,218 Japanese participants, all of whom had type 2 diabetes. Participants were split into four groups, defined by severity of depression. The severity of each patient’s depression was judged using the Centre for Epidemiologic Studies Depression Scale: group one scored nine or less; group two, 10 to 15; group three, 16 to 23; and group four scored 24 or more.
The researchers gathered information about the participants through questionnaires, including alcohol intake, smoking habits, sleeping habits, exercise, episodes of severe hypoglycemia, and how long each participant had had diabetes.
Several health factors were affected by severity of depression, including Body Mass Index (BMI,) exercise levels, smoking, sugar consumptio, insulin use, severe hypoglycemia, risk of foot ulcers, and risk of heart disease.
“In conclusio, this cross-sectional study revealed that severe hypoglycemia was positively associated with the severity of depressive symptoms in Japanese patients with type 2 diabetes independent of glycemic control, insulin therapy, lifestyle factors and diabetic complications,” the researchers wrote.
“Since severe hypoglycemia and depression are known risk factors for morbidity and mortality in patients with diabetes, clinicians should be aware of this combination in clinical settings.”
To some extent, the findings sound obvious. Depression affects a person’s engagement with all aspects of their life, including exercise and sleep. And in people with diabetes, depression is likely to make them less engaged with their diabetes management.
That said, this study provides scientific confirmation that diabetes management gets worse when the patient is depressed. Research like this could lead to mental health being taken more seriously in people with diabetes. Historically, it has not been given the attention it deserves.

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