Abstract
Epidemiologic studies have documented an increased prevalence of depression in patients with diabetes. The pathogenesis of depression in diabetes is complex.
The adverse life events, course and severity of diabetes, neuroendocrine and neuroimmune changes, genetic and personality factors are all likely contributors to its occurrence. The patients with diabetes are at higher risk of developing depression in comparison with healthy persons and depression may increase the risk of developing Type 2 diabetes.
Combination of diabetes and depression could substantially increase the risk of mortality. Depression and diabetes are associated with a significantly increased risk of coronary heart disease.
Both depression and diabetes independently increase the risk of dementia. Complex treatment of the patients with diabetes and comorbid depression comprises psychological support and pharmacological treatment.
Tricyclic antidepressants are not a first choice drug because of their antimuscarinic side effects, mainly cardiotoxicity. Selective serotonin reuptake inhibitors as well as venlafaxine and trazodone are effective in the treatment of depressive symptoms in diabetes.
Antidepressant duloxetine is registered for the treatment of neuropathic pain. However long-term use of antidepressants can increase the risk of developing type 2 diabetes.