Diabetes Psychiatry: The Missing Piece of the Puzzle to Prevent Complications of the Diabetes Pandemic

Both Type 2 Diabetes Mellitus (T2DM) and depression are leading causes of disability despite T2DM being largely preventable and depression being among the most treatable mental health conditions. Diabetes and depression have a bidirectional association, with each condition worsening the development...

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Main Authors: Bradley M. Brooks, Ashley M. Nettles, Brandon M. Brooks
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Psychoactives
Subjects:
Online Access:https://www.mdpi.com/2813-1851/4/2/13
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author Bradley M. Brooks
Ashley M. Nettles
Brandon M. Brooks
author_facet Bradley M. Brooks
Ashley M. Nettles
Brandon M. Brooks
author_sort Bradley M. Brooks
collection DOAJ
description Both Type 2 Diabetes Mellitus (T2DM) and depression are leading causes of disability despite T2DM being largely preventable and depression being among the most treatable mental health conditions. Diabetes and depression have a bidirectional association, with each condition worsening the development and progression of the other. Depression in patients with diabetes is linked with poor glycemic control, reduced treatment adherence, and increased risk of diabetes complications. On the other hand, chronic hyperglycemia, systemic inflammation, insulin resistance, and neuroendocrine dysregulation are involved in the pathophysiology of depression. Antidepressants are often used to treat depression in diabetic patients, but their metabolic impact is still a matter of concern. While some antidepressants like fluoxetine and escitalopram increase insulin sensitivity and improve glycemic parameters, others such as especially tricyclic antidepressants (TCAs) and certain selective serotonin reuptake inhibitors (SSRIs) have been associated with an increased risk of diabetes, weight gain, and poor cardiometabolic outcomes. Considering such complexities, the prescribing of antidepressants must be done carefully. This review underscores the need for evidence-based and patient-centric pharmacological management. Further, the inclusion of psychiatry in multidisciplinary diabetes care teams has the potential to maximize both metabolic and psychological health benefits, as well as reduce the complications of T2DM.
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spelling doaj-art-e68009d86301498c89d1fa39e6bc67b92025-08-20T03:27:22ZengMDPI AGPsychoactives2813-18512025-05-01421310.3390/psychoactives4020013Diabetes Psychiatry: The Missing Piece of the Puzzle to Prevent Complications of the Diabetes PandemicBradley M. Brooks0Ashley M. Nettles1Brandon M. Brooks2USA Department of Psychiatry, University of South Alabama, Mobile, AL 36609, USASurgical Service, Columbia VA Health Care System, Columbia, SC 29209, USASurgical Service, Columbia VA Health Care System, Columbia, SC 29209, USABoth Type 2 Diabetes Mellitus (T2DM) and depression are leading causes of disability despite T2DM being largely preventable and depression being among the most treatable mental health conditions. Diabetes and depression have a bidirectional association, with each condition worsening the development and progression of the other. Depression in patients with diabetes is linked with poor glycemic control, reduced treatment adherence, and increased risk of diabetes complications. On the other hand, chronic hyperglycemia, systemic inflammation, insulin resistance, and neuroendocrine dysregulation are involved in the pathophysiology of depression. Antidepressants are often used to treat depression in diabetic patients, but their metabolic impact is still a matter of concern. While some antidepressants like fluoxetine and escitalopram increase insulin sensitivity and improve glycemic parameters, others such as especially tricyclic antidepressants (TCAs) and certain selective serotonin reuptake inhibitors (SSRIs) have been associated with an increased risk of diabetes, weight gain, and poor cardiometabolic outcomes. Considering such complexities, the prescribing of antidepressants must be done carefully. This review underscores the need for evidence-based and patient-centric pharmacological management. Further, the inclusion of psychiatry in multidisciplinary diabetes care teams has the potential to maximize both metabolic and psychological health benefits, as well as reduce the complications of T2DM.https://www.mdpi.com/2813-1851/4/2/13antidepressantsdiabetes mellitusdepressioninsulin resistancepsychiatryselective serotonin reuptake inhibitors
spellingShingle Bradley M. Brooks
Ashley M. Nettles
Brandon M. Brooks
Diabetes Psychiatry: The Missing Piece of the Puzzle to Prevent Complications of the Diabetes Pandemic
Psychoactives
antidepressants
diabetes mellitus
depression
insulin resistance
psychiatry
selective serotonin reuptake inhibitors
title Diabetes Psychiatry: The Missing Piece of the Puzzle to Prevent Complications of the Diabetes Pandemic
title_full Diabetes Psychiatry: The Missing Piece of the Puzzle to Prevent Complications of the Diabetes Pandemic
title_fullStr Diabetes Psychiatry: The Missing Piece of the Puzzle to Prevent Complications of the Diabetes Pandemic
title_full_unstemmed Diabetes Psychiatry: The Missing Piece of the Puzzle to Prevent Complications of the Diabetes Pandemic
title_short Diabetes Psychiatry: The Missing Piece of the Puzzle to Prevent Complications of the Diabetes Pandemic
title_sort diabetes psychiatry the missing piece of the puzzle to prevent complications of the diabetes pandemic
topic antidepressants
diabetes mellitus
depression
insulin resistance
psychiatry
selective serotonin reuptake inhibitors
url https://www.mdpi.com/2813-1851/4/2/13
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