Type 2 diabetes mellitus and depression

The clinical significance of type 2 diabetes mellitus is not confined to metabolic disorders. A serious problem is also affective pathology that occurs in the majority (30-70%) of patients. However, diagnostics and correction of anxiety and depressive disorders associated with diabetes are often given insufficient attention. Many studies showed relationship between affective disorders and low adherence to the prescribed treatment resulting in general deterioration of clinical prognosis of diabetes. This review article describes the basic mechanisms behind the interrelation of affective disorders and diabetes. The role of persistent subclinical inflammation in diabetes and depression is discussed. The influence of emotional stress on the activation of the hypothalamic-pituitary-adrenal axis on the overproduction of cortisol is emphasized. The similarity of some structural changes in the brain tissue in diabetes and depression is discussed. Effect of endocrine disruption in the emotional sphere is demonstrated. Mechanisms responsible for the development of diabetes and its complications provoked by depression are considered.