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204 Cardio Diabetes Medicine 2017

Anxiety And Diabetes

Dr. Avinash De Sousa
Founder Trustee and Consultant Psychiatrist
Desousa Foundation, Mumbai
&
Ms Pragya Lodha, Research Assistan

Diabetes mellitus is a chronic disorder which arises • having trouble relaxing » being so restless that it’s
as a result of problems in the body’s production and/ hard to sit still
or uptake of insulin. Diabetes mellitus is diagnosed • becoming easily annoyed or irritable
by the presence of abnormally high blood glucose
levels, which is also known as hyperglycemia. Dia- • feeling afraid that something awful might happen.
betes, as known, may be Type 1 (juvenile onset and Diabetes is associated with an increased risk of both
occurs in less than 5-10% of the population suffer- physical and psychological complications, both of
ing from diabetes); Type 2 (adult onset diabetes that which impact the quality of life and overall mortality.
makes up for 90-95% of the cases of diabetes) or Psychological symptomatology is a common occur-
gestational diabetes, a form of high blood sugar af- rence in the pathophysiology of diabetes. It is one
fecting pregnant women. Irrespective of the type, the of the rapidly growing illnesses with every third per-
pathophysiology of diabetes shows comorbidty with son being diagnosed with diabetes. Depression and
several psychiatric disorders. The focus of this article anxiety are highly prevalent psychological disorders
explores the associative links between diabetes and in the population already suffering from diabetes.
anxiety issues.
Though depression is the most investigated psycho-
Not officially, but India is referred to as the diabe- logical disorder associated with diabetes, there has
tes capital, housing approximately 69 million people been little research conducted on the association be-
suffering from diabetes which places the nation on tween diabetes with anxiety. The lack of research is
the second rank after China. Epidemiological studies due to an ambiguity seen in the structural nature of
show an increasing trend for diabetes on a global symptoms of depression and anxiety, for two reason-
level and inevitably in India as well. In support, the (i) there is lack of research on association of symp-
WHO also projects that the morbidity due to diabetes toms and (i) it is difficult to differentiate specific and
will only double between 2016 and 2030. Data from non specific symptoms of depression and anxiety in
the World Health Organization adds an estimate that patients of diabetes.
80 per cent of diabetes deaths occur in low and mid- However, anxiety has been shown to have links with
dle-income countries which places India in a crisis.
poor outcomes in people with diabetes and the re-
Anxiety is when a person experiences an excessive search that has been conducted to study this do-
amount of fear in anticipation of something bad hap- main, shows positive and significant correlational
pening. Usually, this is a healthy response to a real links between diabetes and elevated symptoms of
threat. For example, certain situations, such as public anxiety.
speaking or having a hypo, can trigger anxious feel- Complications arise in diagnosing and delineating
ings. Symptoms of anxiety include:
upon the comorbidity of anxiety in patients who
• feeling nervous or on edge suffer from diabetes. This is attributable to the over-
lapping symptoms of diabetes and anxiety that in-
• being unable to stop worrying or control worrying clude- feelings of fatigue, concentration difficulties,
thoughts
restlessness, change in appetite, irritability and au-
• worrying too much about things tonomic arousal. This difficulty in understanding the

GCDC 2017