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Dr Dheeraj Kapoor, Gurugram 31 January 2018
The prevalence of depression in diabetics is about 3-4 times more than in nondiabetics. The symptomatology also, is of a higher grade in a diabetic. However, severity of symptoms does not correlate with disease severity or with glycemic control. Diabetic complications alone may not cause depression, unless there are functional limitations. Adverse events, personality and genetic factors may also contribute. Anxiety disorders are also commoner in diabetics. Incidence of anorexia and bulimia is not precisely known in diabetes but both disorders can worsen glycemic control. Also, the threshold for reporting of symptoms may be lowered by psychological factors. Interestingly, stress in a diabetic may cause both hyperglycemia and hypoglycemia. Tricyclic antidepressants and nortriptyline may be beneficial in depression. Psychotherapy may have an important role.
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