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Insomnia to fatigue: Diabetics now battle anxiety, depression in Kashmir

Srinagar: World turned upside down for 55-year-old diabetic Hameeda (name-changed) when she began experiencing strong apprehensions about death.

“She was already suffering from uncontrolled diabetes and got diagnosed with major depressive disorder. We immediately put her on anti-depressants, and she is currently doing well. Unfortunately, depression occurrence is two to three times higher in people with diabetes mellitus,” Dr. Junaid Nabi, Assistant Professor Institute of Mental Health and Neurosciences (IMHANS) told The Kashmir Monitor.

Hameeda is not an isolated example. Another 40-year-old female with uncontrolled diabetes began getting anxious due to lack of sleep for days together.

“She came with a history of insomnia. On further examination, she was diagnosed with moderate depression,” Dr. Junaid said. 

Diabetes mellitus is a syndrome with disordered metabolism and inappropriate hyperglycemia due to either the deficiency of insulin secretion or to a combination of insulin resistance and inadequate insulin secretion to compensate. It is a progressive metabolic disorder affecting every aspect of the patient’s life – physical and mental well-being, and no modality of treatment can give dramatic results or halt the progression of the disease.

A research study titled `Depression and diabetes: An experience from Kashmir’ conducted by the Department of Endocrinology, Sher-e-Kashmir Institute of Medical Sciences evaluated the prevalence and the severity of depression among patients with diabetes attending the endocrinology department at the hospital. 

“Among 527 patients taken for the study, depression was present in 39.65% of patients. Depression was more prevalent in the age group of 29–38 years, in females as compared to males, among literates and government employees. The prevalence of depression among Type 1 diabetic patients was 60%, while as in the case of Type 2, it was 37.75%. Depressed patients had higher fasting blood glucose levels as compared to non-depressed diabetic patients,” the study said.

The study published in 2020 in the Indian Journal of Psychiatry concluded that Major Depressive Disorder is inordinately high among adult diabetic patients and a majority of the depressive patients have moderate intensity of Major Depressive Disorder in Kashmir.

“In addition to depression being a consequence of diabetes, depression may also be a risk factor for the onset of diabetes. Depression in diabetes is associated with poor compliance to diabetic treatment, poor glycemic control, and an increased risk of micro and macrovascular complications. It is also associated with decreased glucose tolerance, enhanced insulin secretion, and diminished insulin sensitivity on glucose tolerance test associated insulin resistance,” the study said. 

Dr. Mohammad Hayat Bhat, Consultant Endocrinologist at Govt Superspeciality Hospital, Government Medical College, Srinagar, said there is a significant relationship between diabetes and depression.

“The rapid changes in blood sugar can cause fatigue, anxiety, stress, and eating disorders. Therefore, the patients with diabetes should be screened for depression and referred to appropriate mental health professionals,” Bhat said.