Silent struggles: the link between diabetes and the shadows of depression and suicide

Over the past few decades, the prevalence of diabetes, a serious and complex metabolic disease, has increased to epidemic proportions. The prevalence of diabetes has increased from 108 million in 1980 to 422 million in 20141. Compared to high-income countries, the prevalence has been increasing more rapidly in low-income nations and middle-income nations1. Age-specific diabetes death rates increased by 3% between 2000 and 20191. In 2019, an estimated 2 million fatalities were attributed to diabetes and renal diseases1. Most diabetes treatment guidelines ignore the psychological requirements of the patient and concentrate solely on the medical components of early management2. Many people find it difficult to accept that they will always need to use medicines, which has a negative impact on their ability to manage diabetes and adhere to treatment plans2. Individuals with diabetes have a higher propensity for depression to persist longer, recur, and even result in suicide than those without the disease3. It is imperative that we give this troubling coexistence careful thought and grasp it all. Evidence also suggests that depression and diabetes comorbidity is relatively common4. According to recent estimates, the prevalence of depression is twice as high in patients with diabetes, similar to the general population5. On the other hand, several risk factors, including poor diet, sedentary lifestyle, irregular sleep patterns, and low socioeconomic status, can significantly contribute to the activation of common physiological pathways that both cause and promote diabetes and depression6. However, after tracking 256 036 Taiwanese diabetes patients from 1990 to 2001, Tseng found that 0.8% of deaths were suicide-related (0.14% of all patients)7. Goldston et al.8 examined the prevalence of suicidal behavior and suicidal ideation (SI) in 91 patients with diabetes. According to this study, the lifetime prevalence of SI in adolescents with diabetes was 26.4% (n=24 of 91), which was higher than the rates observed in the general population8. The comorbidity between diabetes and depression is linked to a worse prognosis and more expensive medical care than either condition alone9. It is critical to recognize the pervasive social stigma that surrounds mental health issues and prevents many people with diabetes from receiving critical care. As such, the incorporation of psychological assistance into all-encompassing healthcare initiatives is essential to destigmatize conversations about mental health and to promote a holistic approach to overall wellness. It is also critical that medical professionals receive specific training so that they can recognize the early warning symptoms of depression and SI in individuals with diabetes. Frequent mental health evaluations, empathetic dialog, and customized therapies can be effective strategies for slowing the advancement of mental health issues and reducing startling suicide rates among this susceptible group. Policymakers, medical professionals, and community leaders must collaborate to address this complex issue. It is crucial to create a space that encourages candid communication, provides easily accessible mental health services, and builds a network of support for those coping with the psychological effects of diabetes and related consequences. Our understanding of the complex inter-relationships among diabetes, depression, and suicide paves the way for a time when comprehensive care will emphasize both physical and mental health, guaranteeing that no one will ever feel alone in their pursuit of a better and more satisfying life. Ethical approval This type of article does not need any ethical approval. Consent Patients were not involved in the study. Sources of funding Authors have not received any funds. Author contribution M.O.O.: writing, reviewing, and editing, funding acquisition, and administrative support; A.H.: supervision and data curation. Final approval of manuscript for publication - not applicable. All the authors contributed in conceptualization of ideas, writing the initial draft, and critical review and comments. Conflicts of interest disclosure Authors stated no conflicts of interest. Research registration unique identifying number (UIN) Name of the registry: not applicable. Unique identifying number or registration ID: not applicable. Hyperlink to your specific registration (must be publicly accessible and will be checked): not applicable. Guarantor Malik Olatunde Oduoye. Permission to reproduce material from other sources All articles were cited, and references were given. This study did not use any material that required permission. Provenance and peer review not commissioned, externally peer-reviewed.