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Author: Department of Metabolic Endocrinology, Xiangya Second Hospital of Central South University, Li Fu Xingzi, Chief Physician Yuan Lingqing Mr.
Li is a cheerful and ardent person.
He is often seen helping to maintain public order or clean up public health in the community.
Hearty laughter often drifts in the community.
Over the sky
.
But since he got diabetes last year, Mr.
Li had to spend five to six hundred yuan on medical expenses each month, which made his poor family situation worse
.
It turned out that the sound like Hongzhong and the warm-hearted Mr.
Li are gone, he is not interested in anything, and he sighs or frowns all day long
.
The family took him to see a doctor.
After the doctor checked and asked many questions, Mr.
Li was diagnosed with depression
.
Among many diabetic patients, the number of patients with severe mental disorders such as anxiety, depression, and even schizophrenia is gradually increasing.
However, due to the hidden and complicated clinical symptoms of such patients, clinical attention is not enough, and it is easy to be misdiagnosed or missed.
Mental, psychological and physical health have caused many adverse effects
.
1.
What are the clinical characteristics of diabetes mellitus combined with mental illness? Diagnosed with diabetes, the patient has many ideas.
It is necessary to consider issues such as monitoring blood sugar levels, insulin administration, planning a diet, and maintaining exercise status
.
These will make patients feel physically and mentally exhausted and at a loss.
This is the so-called diabetic burnout
.
Clinically, the onset of the disease is hidden, the recognition is low, and the early clinical diagnosis rate is low
.
It has been found that the common clinical manifestations of diabetes combined with mental and psychological diseases mainly include the following types: neurasthenia syndrome, anxiety and depression, cognitive impairment, hallucinations and delusions, and disturbance of consciousness
.
Among them, anxiety and depression are the most common manifestations
.
Diabetes and depression are more harmful to humans, and the two are often comorbid
.
The relationship between diabetes and depression is two-way, diabetes can be secondary to depression, and depression is also a risk factor for diabetes
.
2.
What are the clinical manifestations of depression? Depression, also known as depressive disorder, is characterized by significant and lasting depression
.
Clinically it can be seen that depression is not commensurate with the situation.
Emotional depression can range from gloomy to grief, low self-esteem, depression, and even pessimism.
There may be suicide attempts or behaviors; even stupor may occur; in severe cases, psychotic symptoms such as hallucinations or delusions may occur.
.
The main manifestations of diabetes with depression are: low mood, loss of interest or happiness, with the characteristics of morning heavy and evening light (morning sadness); slow thinking, poor concentration; low interest, like being alone, withdrawing from friends and activities , Decline in study and work performance; sleep disorders, changes in sleep patterns, early waking is a typical manifestation; suicidal thoughts; decreased libido; feelings of guilt or worthlessness; accompanied by nervousness, anxiety, fatigue, palpitations, chest tightness, gastrointestinal discomfort Or physical symptoms such as constipation
.
3.
Why are people with diabetes prone to have depression? The occurrence of depression is the result of a combination of physical, psychological and social factors
.
The main causes of depression caused by diabetes are: ①Diabetes is a long-term chronic disease.
There is no complete cure.
Patients must always pay attention to diet management, monitor blood sugar frequently, take long-term medication, and some patients need long-term insulin injections.
These are greatly Reduce the patient's quality of life
.
Some patients believe that the use of insulin indicates a serious illness, so the psychological pressure is greater and the pessimism is heavier
.
②If the blood sugar is not well controlled, the patient may have complications within 5 to 10 years
.
③Long-term treatment produces a lot of medical expenses, which brings heavy economic burdens to patients and families, and increases psychological pressure
.
④Long-term hyperglycemia leads to stress-like reactions in the body, elevated plasma levels of cortisol, glucagon and growth hormone, and changes in cortisol activity.
These changes make patients prone to anxiety and depression
.
⑤The psychological burden caused by diabetes can activate stress hormones, thereby worsening blood sugar control, increasing obesity and causing inflammation.
Inflammation may affect the central nervous system and may worsen mental health
.
4.
What is the harm of diabetes and depression? Diabetes combined with depression is very harmful, because depression and diabetes can interact, cause and effect each other, forming a vicious circle
.
Diabetes can cause inconvenience in life and physical and mental pain to patients.
In addition, the final outcome of the development of diabetes will cause complications in important organs (such as eyes, kidneys, nerves, cardiovascular and cerebrovascular, etc.
), causing many patients As a result, I was burdened with heavy mental pressure
.
This negative emotion can not only affect the patient's compliance with treatment, but also cause neuroendocrine disorders
.
In addition, the following hazards may occur in diabetic patients when they are depressed: ①When the patient is in a state of stress, the secretion of cortisol increases, which reduces the utilization of glucose, inhibits the secretion of insulin, and stimulates sympathetic nerves and increases the secretion of catecholamines, leading to increased blood sugar.
, Accelerate the occurrence of complications
.
② Mood disorder itself can directly cause abnormal immune function and increase the probability of diabetes
.
③Negative emotions make the patients lack of diet control, poor compliance with hypoglycemic therapy, and unsatisfactory blood sugar control
.
Conversely, poor blood sugar control will worsen the condition, which will make the patient more pessimistic and disappointed, and aggravate the patient's depression
.
In addition to severe depression can lead to aggravation of diabetes, it can even lead to serious consequences such as suicide
.
5.
How to treat diabetes with depression? Elderly diabetic patients or those with impaired consciousness, because their condition changes quickly, recovery is slower, and the mortality rate is also higher
.
For patients with diabetes and depression, it is necessary to formulate an individualized hypoglycemic plan, try to choose drugs that are simple to take, easy to operate, and have low risk of hypoglycemia
.
A series of psychosocial treatments can be used thereafter
.
Through the implementation of diabetes education, patients' misunderstandings about diabetes are corrected, and patients are informed that diabetes is not an incurable disease, so as to relieve their pessimism and mental pressure, help patients build confidence in overcoming the disease, and enable them to actively cooperate with treatment
.
When a patient has negative emotions, you can take a variety of measures to stop it: take a breath; take a deep breath; drink water; sit down; lean back; shake your arms; try to silence yourself; take a walk
.
In addition, the whole society should actively extend a helping hand, dedicate love, and alleviate its economic worries
.
For patients with severe depression, antidepressants can be given under the guidance of a doctor
.
In addition, exercise and cognitive behavioral therapy (CBT), whether used alone or in combination, can significantly alleviate the symptoms of depression in patients with type 2 diabetes
.
Pioglitazone alone or as an add-on to conventional treatment can induce depression remission
.
Drugs with PPAR-γ agonist properties may be clinically relevant antidepressants
.
Source: Friends of Diabetes
Li is a cheerful and ardent person.
He is often seen helping to maintain public order or clean up public health in the community.
Hearty laughter often drifts in the community.
Over the sky
.
But since he got diabetes last year, Mr.
Li had to spend five to six hundred yuan on medical expenses each month, which made his poor family situation worse
.
It turned out that the sound like Hongzhong and the warm-hearted Mr.
Li are gone, he is not interested in anything, and he sighs or frowns all day long
.
The family took him to see a doctor.
After the doctor checked and asked many questions, Mr.
Li was diagnosed with depression
.
Among many diabetic patients, the number of patients with severe mental disorders such as anxiety, depression, and even schizophrenia is gradually increasing.
However, due to the hidden and complicated clinical symptoms of such patients, clinical attention is not enough, and it is easy to be misdiagnosed or missed.
Mental, psychological and physical health have caused many adverse effects
.
1.
What are the clinical characteristics of diabetes mellitus combined with mental illness? Diagnosed with diabetes, the patient has many ideas.
It is necessary to consider issues such as monitoring blood sugar levels, insulin administration, planning a diet, and maintaining exercise status
.
These will make patients feel physically and mentally exhausted and at a loss.
This is the so-called diabetic burnout
.
Clinically, the onset of the disease is hidden, the recognition is low, and the early clinical diagnosis rate is low
.
It has been found that the common clinical manifestations of diabetes combined with mental and psychological diseases mainly include the following types: neurasthenia syndrome, anxiety and depression, cognitive impairment, hallucinations and delusions, and disturbance of consciousness
.
Among them, anxiety and depression are the most common manifestations
.
Diabetes and depression are more harmful to humans, and the two are often comorbid
.
The relationship between diabetes and depression is two-way, diabetes can be secondary to depression, and depression is also a risk factor for diabetes
.
2.
What are the clinical manifestations of depression? Depression, also known as depressive disorder, is characterized by significant and lasting depression
.
Clinically it can be seen that depression is not commensurate with the situation.
Emotional depression can range from gloomy to grief, low self-esteem, depression, and even pessimism.
There may be suicide attempts or behaviors; even stupor may occur; in severe cases, psychotic symptoms such as hallucinations or delusions may occur.
.
The main manifestations of diabetes with depression are: low mood, loss of interest or happiness, with the characteristics of morning heavy and evening light (morning sadness); slow thinking, poor concentration; low interest, like being alone, withdrawing from friends and activities , Decline in study and work performance; sleep disorders, changes in sleep patterns, early waking is a typical manifestation; suicidal thoughts; decreased libido; feelings of guilt or worthlessness; accompanied by nervousness, anxiety, fatigue, palpitations, chest tightness, gastrointestinal discomfort Or physical symptoms such as constipation
.
3.
Why are people with diabetes prone to have depression? The occurrence of depression is the result of a combination of physical, psychological and social factors
.
The main causes of depression caused by diabetes are: ①Diabetes is a long-term chronic disease.
There is no complete cure.
Patients must always pay attention to diet management, monitor blood sugar frequently, take long-term medication, and some patients need long-term insulin injections.
These are greatly Reduce the patient's quality of life
.
Some patients believe that the use of insulin indicates a serious illness, so the psychological pressure is greater and the pessimism is heavier
.
②If the blood sugar is not well controlled, the patient may have complications within 5 to 10 years
.
③Long-term treatment produces a lot of medical expenses, which brings heavy economic burdens to patients and families, and increases psychological pressure
.
④Long-term hyperglycemia leads to stress-like reactions in the body, elevated plasma levels of cortisol, glucagon and growth hormone, and changes in cortisol activity.
These changes make patients prone to anxiety and depression
.
⑤The psychological burden caused by diabetes can activate stress hormones, thereby worsening blood sugar control, increasing obesity and causing inflammation.
Inflammation may affect the central nervous system and may worsen mental health
.
4.
What is the harm of diabetes and depression? Diabetes combined with depression is very harmful, because depression and diabetes can interact, cause and effect each other, forming a vicious circle
.
Diabetes can cause inconvenience in life and physical and mental pain to patients.
In addition, the final outcome of the development of diabetes will cause complications in important organs (such as eyes, kidneys, nerves, cardiovascular and cerebrovascular, etc.
), causing many patients As a result, I was burdened with heavy mental pressure
.
This negative emotion can not only affect the patient's compliance with treatment, but also cause neuroendocrine disorders
.
In addition, the following hazards may occur in diabetic patients when they are depressed: ①When the patient is in a state of stress, the secretion of cortisol increases, which reduces the utilization of glucose, inhibits the secretion of insulin, and stimulates sympathetic nerves and increases the secretion of catecholamines, leading to increased blood sugar.
, Accelerate the occurrence of complications
.
② Mood disorder itself can directly cause abnormal immune function and increase the probability of diabetes
.
③Negative emotions make the patients lack of diet control, poor compliance with hypoglycemic therapy, and unsatisfactory blood sugar control
.
Conversely, poor blood sugar control will worsen the condition, which will make the patient more pessimistic and disappointed, and aggravate the patient's depression
.
In addition to severe depression can lead to aggravation of diabetes, it can even lead to serious consequences such as suicide
.
5.
How to treat diabetes with depression? Elderly diabetic patients or those with impaired consciousness, because their condition changes quickly, recovery is slower, and the mortality rate is also higher
.
For patients with diabetes and depression, it is necessary to formulate an individualized hypoglycemic plan, try to choose drugs that are simple to take, easy to operate, and have low risk of hypoglycemia
.
A series of psychosocial treatments can be used thereafter
.
Through the implementation of diabetes education, patients' misunderstandings about diabetes are corrected, and patients are informed that diabetes is not an incurable disease, so as to relieve their pessimism and mental pressure, help patients build confidence in overcoming the disease, and enable them to actively cooperate with treatment
.
When a patient has negative emotions, you can take a variety of measures to stop it: take a breath; take a deep breath; drink water; sit down; lean back; shake your arms; try to silence yourself; take a walk
.
In addition, the whole society should actively extend a helping hand, dedicate love, and alleviate its economic worries
.
For patients with severe depression, antidepressants can be given under the guidance of a doctor
.
In addition, exercise and cognitive behavioral therapy (CBT), whether used alone or in combination, can significantly alleviate the symptoms of depression in patients with type 2 diabetes
.
Pioglitazone alone or as an add-on to conventional treatment can induce depression remission
.
Drugs with PPAR-γ agonist properties may be clinically relevant antidepressants
.
Source: Friends of Diabetes
