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Depression increases Cardiovascular Risk

Apart from sugary foods and cigarette smoke, diabetics should start avoiding excess depression too.

A study revealed that overtly depressed adults with type 2 diabetes run a higher risk of having microvascular and macrovascular complications, despite having good health maintenance. Microvascular complications include eye, kidney and nerve complications, leading to blindness, kidney failure and severe numbness and weakness of the extremities and other parts of the body. Macrovascular complications include narrowing of the arteries in the heart, brain and peripheral or leg circulation leading to heart attack, stroke and leg amputations.

Data showed that major depression can raise a diabetic’s risk of having microvascular complications and macrovascular complications by as much as 36 percent and 25 percent, respectively. This is compared to type 2 diabetic individuals with little or no stress.

The researchers surveyed 4,623 type 2 diabetic adults between 2000-2002, taking note of the participant’s past complications with diabetes and their current state of depression. Five years later in 2007, the researchers once again surveyed 3,922 of the original participants (approximately 81 percent), this time inquiring about the occurrence of the said complications during the past.

“After adjustment for prior complications, demographic, clinical and diabetes self-care variables, major depression was associated with significantly higher risks of adverse microvascular outcomes and adverse macrovascular outcomes.” However, apart from the discrepancy brought about by the participant’s individual lifestyle, no depression data had been collected prior to the start of the study, not to mention that the demographics was focused on a single area, which could have limited the results.

The association between depression and the rise of complications can be attributed to the triggering of the part of the brain called hypothalamic-pituitary-adrenal axis whenever an individual is depressed or stressed. This would then arouse the sympathetic nervous system, which increases the tendency of the blood to clot (platelet aggregation) and cause poor blood-sugar control, increasing further the risk of complications.

“Clinical and public health significance of these findings rises as the incidence of, type 2 diabetes soars,” said the authors. “Further research is needed to clarify the underlying mechanisms for this association and to test interventions to reduce the risk of diabetes complications among patients with co-morbid depression.”

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