The lowdown on diabetes

First, the bad news. If you are old and depressed, the chances of your getting diabetes are higher, says a new study. But the good news is that you can control it with care and family support.

First, the bad news. If you are old and depressed, the chances of your getting diabetes are higher, says a new study. But the good news is that you can control it with care and family support.

What does the study say?
Elderly people who are depressed are more likely to get diabetes than those who are not, says a study in the prestigious Archives of Internal Medicine. It suggests depression may play a role in causing the most common form of diabetes. According to researchers, people with more symptoms of depression are about 60 per cent more likely to develop Type II diabetes, formerly called adult-onset diabetes, than people who don’t suffer from depression.

Does that hold in India as well?
Yes, say doctors. “About 40-50 per cent people beyond 50 years are in some stage of diabetes.
Either it is pre-diabetes or they are fully blown diabetics. The chances increase with age,’’ says Dr Anoop Mishra, director of diabetes and metabolic diseases at Fortis Hospital, Delhi.

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How can depression be a risk?
According to experts, there are various factors at play. ‘’The factors can be either physiological or consequences of an impaired lifestyle,’’ adds Dr Mishra. Let’s take a look:
The body produces hormones that affect metabolism. During depression, the body can produce counter-regulatory hormones, which counter the effect of insulin in the body. This can induce diabetes or aggravate the condition.
Some drugs for depression have a similar effect on insulin—they decrease its action. These new generation anti-psychotics disregulate blood sugar.
Depression’s impact on lifestyle is already known. Diabetics usually don’t take their medicines on time, which causes problems as altered dosage can aggravate sugar levels. Also, some people tend to eat more if they are depressed and this can induce diabetes.
People with depression usually tend to be less physically active and thus are more likely to gain weight—the primary risk factor for diabetes.

How difficult is it to manage diabetes among the elderly?
It is certainly a challenge. Managing diabetes is more complex in the elderly as they have other physical problems as well. Impaired physical functioning among some elderly patients can mean that adjusting to a diabetes’ care routine is more difficult. Cognitive impairment can also be a factor that complicates treatment.

How can one avoid depression and diabetes among the elderly?
Findings point to the importance of doctors screening adults for depression and, if it’s present, for diabetes.
Senior citizens who can no longer drive may have difficulty keep medical appointments and maintain an appropriate diabetes preventative care. So, help them meet their appointments.
Food is another area of concern. Make sure elders in the family eat at regular intervals—-at least three times a day. They should have more fruits and nuts.
If you are old, don’t hit the bottle. Alcohol is high in sugar content and is best left alone.
Take the elderly for regular eye and foot check-ups.