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Probing depression and its ties to diabetes - Health & Science - International Herald Tribune

Probing depression and its ties to diabetes - Health & Science - International Herald Tribune

Although the evidence is growing, they also said there is not yet proof that depression causes diabetes, and there are no definitive explanations of what underlies the connection. But scientists are turning up some clues.

A study at the Joslin Diabetes Center in Boston, published in the journal Diabetes in February, found differences in the brains of people with and without Type 1 diabetes. The brains of diabetics were less dense and less responsive in an area of the prefrontal cortex that helps control emotions and is believed to contribute to depression, said Dr. Alan Jacobson, director of behavioral and mental health research at the Joslin.

Future research is planned to help explain how these changes affect behavior and whether they get worse over time.

Other scientists are looking at the stress hormone cortisol, which builds up in many depressives. Cortisol decreases the body's production of insulin and reduces sensitivity to insulin's effects, which are key characteristics of diabetes. Without enough insulin, the body can't use food to fuel activity.

"That could be the direct link," said Pat Lustman, a professor of psychiatry at Washington University in St. Louis, Missouri. Lustman is testing whether using diet and exercise or drugs to improve insulin sensitivity will boost the effect of antidepressants. Already, other research suggests that easing depression improves diabetics' control of their blood sugar, possibly by improving their body's ability to cope and certainly by increasing their willingness to work at it.

One study, presented in June at the American Diabetes Association meeting, suggested that antidepressants themselves might be part of the connection between depression and diabetes.

[...]

The researchers can't explain the puzzling results. But Richard Rubin, an associate professor at the Johns Hopkins University School of Medicine in Baltimore, who led the study, urged patients not to give up on antidepressants, since the study did not prove that the drugs caused diabetes.

Another part of the puzzle might be disruptions of the immune system that cause inflammation. Both Type 2 diabetes and depression are marked by increased cytokines, immune system proteins that carry messages to the hypothalamus, a part of the brain that helps regulate both mood and blood sugar levels. Researchers are testing treatments that reduce inflammation.

The Dutch group studying depression and diabetes is pursuing a related avenue - that omega-3 fatty acids are a crucial link. These substances, which occur in some fish and plant oils, help brain cells communicate and help reduce inflammation. Low levels of omega-3 fatty acids are linked to depression and may reduce the body's ability to control blood sugar.

The group is testing whether doses of omega-3 fatty acids can both improve mood and reduce insulin resistance in diabetics who are depressed.

Depression and Diabetes go in hand. Some say that diabetes just sucks and makes people sad. Others say that depression could cause diabetes, by increasing levels of the stress hormone cortisol. Research is ongoing, but I wouldn't be surprised if there is a psiological connection between the two. Mind and body are connected in many different ways. Once again there's an inflammation/omega3 angle to this story.

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