The connection between mental health and diabetes

Research shows men face an increased risk of developing the chronic disease when psychological factors are considered

Nisa Drozdowski - 22 November 2019

More than 400 million people worldwide live with Type 2 diabetes (T2D). T2D is one of the many chronic conditions that continues to grow in terms of numbers of people diagnosed and as a percentage of the population. These numbers have increased steadily over the past decades and continue to do so, creating a global public health crisis.

"The onset of Type 2 diabetes results from a number of different risk factors, not a single predictor," explains Jeff Johnson, a professor in the School of Public Health and director of the Alliance for Canadian Health Outcomes Research in Diabetes (ACHORD), which is part of the Alberta Diabetes Institute at the University of Alberta. "It is the interactions of multiple factors that tend to increase the risk of developing the chronic disease," says Johnson.

Behavioural factors that put an individual at risk of T2D include smoking, unhealthy eating and inactivity. Physiologic measures, such as high blood pressure and obesity, also contribute to risk. Alongside these traditional factors, psychological factors such as depression and anxiety are increasingly recognized as contributing to the development of T2D.

Johnson collaborated with researchers from Norway and the University of Ottawa and to examine a specific combination of behavioural factors, metabolic syndrome and the presence of depression and anxiety on T2D. The work is significant in that it is among the first to quantify the additional risk associated with added psychological factors-with unexpected findings.

Overall, the combination of risk factors accounted for 50 per cent of new diabetes cases amongst Norwegian adults. However, there was a much higher proportion of men (78 per cent) than women (47 per cent) in the group who were affected.

"We were surprised to see a higher risk for men developing T2D when these psychological symptoms were considered," says Johnson.

Most countries invest in programs aimed at reducing the main modifiable risk factors for T2D, such as obesity, smoking, unhealthy eating and inactivity. Johnson says while these public health programs and messages remain the same, it's important to also encourage people to seek support for psychological symptoms.

"This approach is particularly important for men, who may be accustomed to not talking about their feelings," says Johnson. "From there, you can develop a plan with your health-care provider for how to manage symptoms when they come up."

People living with T2D are often also living with other chronic conditions, like obesity, heart disease, arthritis or chronic obstructive pulmonary disorder. As a result, their overall health is poorer than the rest of the population. They may not be able to work or live life to the fullest extent possible.

Living with chronic conditions can trigger psychological risk factors, and vice versa. "Depression can trigger unhealthy eating patterns or lethargy, which can contribute to weight gain," explains Johnson.

Type 2 diabetes is becoming so common that it is likely that someone you know is living with this condition, or will develop it in the future. Johnson says that since it is largely preventable, we can help maintain our health, and theirs, by making healthy choices.

"Making healthy choices-being physically active, making healthy food choices and taking time for yourself-is one way to gain some control and confidence to help reduce those feelings of sadness and anxiety."

"With increasing costs and limited funds, we should be concerned about how efficient and effective our health-care system is, and if we can reduce the costs overall by having a healthier population, we can make everyone better off."