title: NIDDK international conference report on diabetes and depression: current understanding and future directions.
abstract: Comorbid diabetes and depression are a major clinical challenge as the outcomes of each condition are worsened by the other. This article is based on the presentations and discussions during an international meeting on diabetes and depression convened by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) in collaboration with the National Institute of Mental Health and the Dialogue on Diabetes and Depression. While the psychological burden of diabetes may contribute to depression in some cases, this explanation does not sufficiently explain the relationship between these two conditions. Shared biological and behavioral mechanisms, such as hypothalamic-pituitary-adrenal axis activation, inflammation, autonomic dysfunction, sleep disturbance, inactive lifestyle, poor dietary habits, and environmental and cultural risk factors, are important to consider in understanding the link between depression and diabetes. Both individual psychological and pharmacological depression treatments are effective in people with diabetes, but the current range of treatment options is limited and has shown mixed effects on glycemic outcomes. More research is needed to understand what factors contribute to individual differences in vulnerability, treatment response, and resilience to depression and metabolic disorders across the life course and how best to provide care for people with comorbid diabetes and depression in different health care settings. Training programs are needed to create a cross-disciplinary workforce that can work in different models of care for comorbid conditions.
authors: Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, U.K. r.i.g.holt@soton.ac.uk.
authors: Richard I G
authors: RI
authors: Holt
authors: Diabetes Translational Research Center, Indiana University School of Medicine, Indianapolis, IN.
authors: Mary
authors: M
authors: de Groot
authors: Department of Psychiatry, University of Pennsylvania, Philadelphia, PA.
authors: Irwin
authors: I
authors: Lucki
authors: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD.
authors: Christine M
authors: CM
authors: Hunter
authors: Association for the Improvement of Mental Health Programmes and the Dialogue on Diabetes and Depression, Geneva, Switzerland.
authors: Norman
authors: N
authors: Sartorius
authors: Departments of Medicine and Epidemiology, Johns Hopkins University Schools of Medicine and Public Health, Baltimore, MD.
authors: Sherita H
authors: SH
authors: Golden
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D003226:Congresses as Topic; D003866:Depressive Disorder / Q000209:etiology* / Q000503:physiopathology; D003920:Diabetes Mellitus / Q000503:physiopathology / Q000523:psychology*; D003928:Diabetic Nephropathies / Q000503:physiopathology / Q000523:psychology; D005544:Forecasting; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology; D007249:Inflammation / Q000503:physiopathology; D010913:Pituitary-Adrenal System / Q000502:physiology; D012307:Risk Factors; D057185:Sedentary Behavior; D012893:Sleep Wake Disorders / Q000523:psychology; D014481:United States
chemical_list: D001786:Blood Glucose