Just as cardiovascular disease exists within the South Asian population at alarming rates, diabetes rates are also exceptionally high. South Asians are 3-6 times more likely to develop diabetes than Caucasians, acquire the disease at an earlier age and at a lower body mass index than Americans, Europeans and all other minority immigrants. Researchers still do not know why but have several theories related to South Asian genetics that predisposes the community to developing the disease at such high rates.
Complicating the prognosis of diabetes is the prevalence of depression. It is unclear which causes the other, but there is a definite bi-directional link between the two. In other words, living with depression significantly increases the chance of developing diabetes and being diagnosed with diabetes increases the risk of depression. One possible explanation is that both diabetes and depression are connected closely behaviorally and biologically. 
Dr. Hu at Harvard School of Public Health, who recently published a study on this connection, states that the common factor between depression and diabetes is stress. People who are depressed have higher levels of stress hormones in their body (such as cortisol) which can negatively affect glucose levels, blood sugar metabolism, accumulation of fat cells and an increase of insulin resistance, all of which are serious risk factors for diabetes.
On the flip side, people who are diagnosed with diabetes experience higher levels of stress with regards to symptom management. Dr. Hu guesses that necessary lifestyle changes and constant monitoring of symptoms can increase stress, decrease the quality of life and thus increase the development of depression.
Diabetes management requires significant levels of self-care (including monitoring food intake, blood sugar levels, and exercise routines). However, people with depression usually do not take care of themselves very well, which might help explain the close connection between depression and diabetes rates. According to the American Diabetic Association, depression affects about 3-5% of the general population but affects about 15-20% of patients with diabetes.
When the two co-exist, each becomes more difficult to manage, increasing the risk of cardiovascular disease, blindness and other complications. In fact, in a recent study, researchers found that depression that co-existed with diabetes was a greater risk factor for heart disease than high blood sugar. Additionally, a study conducted by Dr. Pan at the Harvard School of Public Health concluded that the comorbidity of depression and diabetes is associated with a significant increase in mortality due to cardiovascular disease.
Thus, it is essential that both depression and diabetes symptoms be taken very seriously. In addition, depression management must be built into the self-care program developed for patients with diabetes and that sugar levels and early signs of diabetes be monitored and identified in people living with depression. The co-existence of both disorders can have very serious and life-threatening consequences, so it is very important that if you have one, you prevent the development of the other.
If you notice yourself experiencing any of the signs or symptoms of depression, it is essential that you be treated immediately to reduce the risk of developing diabetes. Follow your treatment regimen provided by your doctor or mental health care professional, get enough sleep and reduce stress levels.
If you have been diagnosed with diabetes, see a doctor or mental health care professional immediately for a depression screening and follow the treatment guidelines carefully in accordance with the results of the screening. Understand that living with depression can make the diabetes significantly worse.
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