title: Death by Insulin: Management of Self-Harm and Suicide in Diabetes Management.
abstract: Suicide is the tenth leading cause of death in Americans of all ages. Presence of a chronic medical illness (e.g. Diabetes mellitus) increases the risk of suicide. The goal of this review is to examine the relationship between diabetes and depression, as well as diabetes and suicide. Earlier this year, the U.S. Preventive Task Force (USPTF) escalated their recommendation for depression to include not only routine screening for depression but additional focus on active follow up that requires measurement based care. As a result, it is important that persons with diabetes are also screened for suicidal ideation in the presence of a mood disorder. Due to the higher risk and access to potentially lethal medications in persons with diabetes, risk mitigation procedures should be in place that includes not only depression and suicide screening but also the use of inter-disciplinary teams. Appropriate medical monitoring is essential following a suicide attempt to avoid death particularly because these patients are prone to repeat attempts.
authors.affiliation: North Shore University Hospital and Assistant Professor Hofstra Northwell School of Medicine, Hempstead, NY, 300 Community Drive, Manhasset, NY, 11030. United States.
authors.forename: Alyson K
authors.initials: AK
authors.lastname: Myers
authors.affiliation: Betty Jo Hay Distinguished Chair in Mental Health, Director Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas. United States.
authors.forename: Madhukar H
authors.initials: MH
authors.lastname: Trivedi
mesh_terms: D003863:Depression / Q000209:etiology*; D048909:Diabetes Complications / Q000188:drug therapy / Q000523:psychology*; D019468:Disease Management; D006801:Humans; D007328:Insulin / Q000008:administration & dosage* / Q000009:adverse effects; D016728:Self-Injurious Behavior / Q000139:chemically induced*
chemical_list: D007328:Insulin
keywords: Depression; diabetes; insulin pump; overdose; suicide attempt