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Depression may be independent risk for diabetic eye disease

Kathleen Blanchard's picture

Diabetics with depression have a higher chance of developing retinopathy, finds a new study. Even after adjusting for obesity, poor blood sugar control, sedentary lifestyle and smoking, researchers still found increased risk for the serious eye disease that can lead to blindness.

According to study co-author Wayne Katon, M.D., it may be that diabetes combined with untreated depression causes biological changes leading to higher cortisol levels and blood clotting that damages the blood vessels in the eyes.

In their study that included 2,359 patients with diabetes enrolled in the Pathways Epidemiologic Study, 22.9 percent of diabetic with self-reported major depression developed the eye disease that can lead to blindness, compared to 19.7 percent with no depression.

“There is no question that the burden of depression among patients with diabetes is very high and that depression is a risk factor for worse outcomes in patients with diabetes, as was seen in this study,” said Todd Brown, M.D., an assistant professor of medicine at the division of endocrinology and metabolism at Johns Hopkins University.

Depression is known to worsen outcomes for people with diabetes and leads to higher rates of complications.

The authors say it may be that diabetics with depression are less likely to go to the doctor and are less active, contributing to the study finding.

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“The big question with all of this is whether identifying and treating depression in patients with diabetes will change clinical outcomes,” Brown said. “And currently, there are no universal recommendations for depression screening among patients with diabetes.”

Retinopathy is a leading cause of blindness, according to the National Institutes of Health. The serious eye disease can affect people with type 1 and type 2 diabetes. Almost everyone with diabetes more than 30 years will develop some form of eye damage from retinopathy that causes damage to the blood vessels that nourish the retina of the eye.

There are treatments, but once damage occurs it is irreversible. Symptoms of diabetic retinopathy include blurred vision, floaters, seeing shadows, difficulty seeing in dim light, pain in one or both eyes, headache blind spots and double vision. Early treatment leads to the best outcomes.

Managing blood sugar levels and remaining active can help prevent retinopathy. Speak with your doctor if you have diabetes and experiencing depression.

Annual eye exams are important to diagnose diabetic retinopathy early. The new study found depression may be an independent risk factor for those with diabetes for developing the serious eye disease that can destroy quality of life, the ability to live independently and lead to falls and higher rates of hospitalization.

General Hospital Psychiatry: doi:10.1016/j.genhosppsych.2011.05.021
Nida Sieu M.D., M.P.H et al.’; July, 2011

Health Behavioral News Services

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