The dynamic psychoendocrine relation between diabetes mellitus and mental health disorders: A review of the literature

Background Diabetes Mellitus (DM) is a metabolic disease secondary to the abnormal rise in serum blood glucose. The worldwide spread of DM makes it a well-known studied and researched noncommunicable disease. Its inadequate care and control can definitely lead to a decline in overall health and likely increase in mortality. Although cardiovascular, cerebrovascular, and nephrologic diseases are the main associated comorbidities with DM, an important aspect to acknowledge is the interweaved psyschoendocrine (PSE) relation that DM and Mental Health Disorders (MHD) have in possible causality. Objective This article aims to review the dynamic PSE relation between DM and MHD, shedding light on this overlooked interaction. Methods The research team used a computerized search for articles published in Medline and PubMed. We used terminology linked to DM and MHD in our search. Discussion The domain of MHD, including psychiatric diseases and compliance to therapy or lack of it, might exhibit a link with blood sugar control in DM patients. The same could be considered regarding the state of DM's control and the rise or exacerbation of MHD. A better understanding of these two vast windows of disorder groups is needed in order to achieve optimum patient care. Multiple sources of literature suggest this dynamic interrelationship between the two groups with examples of worse blood glucose control and DM prevalence seen in patients with mood and anxiety disorders, psychotic disorders, eating disorders, and personality disorders. Cognitive behavioral therapy (CBT) seems to show some roles in improving glycemic control in certain MHD groups while some studies implied no significance. The literature also suggests a role for anti-diabetic pharmaceuticals in terms of association with MHD. Conclusion A dynamic causal relationship exists between DM and MHD. Worse MHD outcomes are seen in patients with poor blood glucose control, and in T2DM patients with inadequately treated MHD. Thorough PSE investigation of the hypothalamic pituitary adrenal (HPA) axis is a topic that could be a place for further future research.