Understanding The Connection Between Diabetes And Depression

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Author(s): 
James Wrobel, DPM

When it comes to patients with diabetes, the important roles of depression and distress have received more attention in the literature within the past year.1-6 While these topics are typically off our radar screens, having a stronger understanding of these connections can enable podiatric physicians to make meaningful differences in our patients’ lives. We care for patients in transitional health states across the continuum of care when these problems are more likely to surface. We also have more frequent contacts that can make us more sensitive and responsive to subtle changes in our patients’ mental health.
It is hardly a stretch to say that treating patients with diabetes can present a large challenge. Frequently our patients have lost the important sensory feedback loop of the gift of pain.7 This is coupled with emotional, mental, familial, occupational and social challenges of adhering to a demanding treatment regimen and prescribed lifestyle changes. All of this can rapidly cascade into frustrating clinical encounters in which little progress happens from both the physician and patient perspectives.
How can the podiatric physician possibly address these issues in an effective manner during a 15-minute encounter in a busy practice?4 Fortunately, there are a couple of simple clinical pearls and important signals that can better elucidate these important clinical states in our patients.4,8,9

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