Depressive states weaken the attention of a diabetic patient to compliance with the mandatory requirements of the daily treatment and prophylactic regimen. Here, the patient is trapped by many “underwater reefs”: he often ceases to follow dietary prescriptions, violates does not follow insulin injections and other medications, sometimes stops taking them altogether, refuses regular blood glucose tests …
As a result of depression control over the course of diabetes is lost and the maintenance of its stable compensation, the threat of diabetes complications increases.
To some extent, depressive states are associated with such a dangerous clinical form of diabetes as “labile diabetes” with its inherent sharp fluctuations in blood sugar levels (during the day, its content in the blood can fluctuate between 2.5-3.0 up to 23-25 mmol / l and more).
Many experts attribute such a labile course of diabetes not so much to pathophysiological, but to psychological and behavioral characteristics of the patient’s personality. By the way, depressive conditions are accompanied by an increase in the blood levels of counter-insulin stress hormones (cortisol, etc.).
The mechanism of the onset of depression in patients with diabetes is the subject of special scientific research; there is still a lot of unclear interpretation and explanation. There are two main assumptions.
- depressive states are the result of metabolic (biochemical) changes inherent in diabetes.
- depression is the result of the influence of unfavorable social and psychological factors that inevitably arise in the patient’s life. Most likely, both of these reasons are combined.
The pathogenetic basis of diabetic depression is based on genetic factors, and in particular — on metabolic disorders. Scientific studies have revealed that a deficiency in the body of the so-called biogenic amines — norepinephrine, serotonin and dopamine — is involved in the genesis of depressive conditions.
It is assumed that genetically determined depressive conditions are caused by the peculiarities of the hereditary mechanism of serotonin transport. It has also been established that some drugs (antibiotics, analgesics, chemicals, beta-blockers, and others) may be involved in the onset of depressive conditions.