Beneficiary Conversation

Beneficiary Conversation

Holly: Today we are going to talk a bit about how diabetes and depression can be commonly diagnosed together and ways that we work as a team to help patients like you improve self-management of your symptoms.

As you probably already know, diabetes is a cluster of diseases that involve problems with the production or utilization of insulin.

The pancreas normally releases insulin to help the body use glucose and fat from food that we eat for energy but sometimes the pancreas doesn’t create any insulin or enough insulin. When this happens, diabetes results.

There are 2 types of diabetes—type 1 where the body doesn’t produce any insulin, and type 2 where the body doesn’t make enough insulin or the body no longer responds to insulin the way it used to.

A few common symptoms of type 1 are increased thirst or hunger, dry mouth, frequent urination, losing weight all of a sudden, feeling tired, difficulty seeing clearly, breathing more heavily, and in some cases, losing consciousness.

Common symptoms of type 2 include slow healing cuts on the body, itchy/dry skin, yeast infections, weight gain, numbness/tingling in hands/feet, or erectile dysfunction.

As a medical provider, I often find that many people with diabetes also have depression.

I have a member of the primary care team with me, Dr. Winford who is a behavioral health consultant, who will explain a bit more about what happens when someone has both diabetes and depression.

Eboni: Depression and diabetes are really common. In fact, up to 45% of people with diabetes also have depression that hasn’t be diagnosed or treated.

Having depression can increase someone’s risk of getting diabetes in the future, and it often makes it harder for someone with diabetes to take good care of their symptoms.

Let’s talk a bit about what depression is.

When someone is depressed, they may feel sad, have little energy, have a poor appetite (or overeat), may sleep more than usual or have a hard time sleeping, have difficulty concentrating or remembering things, and they may even have thoughts that they would be better off dead.

As Dr. Robertson was saying, having depression and diabetes sometimes makes treatment harder for you as the patient and for your medical doctor.

When someone feels really sad or has little energy or feels down often, it can be hard to get up and check your blood sugars or give yourself insulin multiple times a day.

That’s where being really honest with your medical provider and your family members about how you feel and your mood symptoms can go a long way.

Dr. Robertson, I wonder if you could explain some of the things that you’d like patients or family members to share with you when it comes to managing their diabetes.

Holly: As a medical provider, it’s often really helpful to hear if a patient is having any trouble with the recommendations I give them.

For example, are they having a hard time checking their blood sugars? Are they having a hard time giving themselves insulin or taking any oral medications that I’ve prescribed? Are they having trouble eating a healthy range of foods that aren’t high in sugars or other carbs, for example?

Eboni: What about their mood? What do you want them to tell you about how they feel?

Holly: It helps me to help patients best when I know if they are feeling sadder than usual.

For example, if I give a patient a new diagnosis of diabetes, a little sadness for a little while is completely normal but if they are sad all the time and it is getting in the way of their being able to take care of themselves or their ability to do things that matter to them, I’d want the patients or their loved ones to let me know about that.

Eboni: It sounds like you really need to know about more than just the physical factors but also the behavioral health factors that may affect the way they manage their own diabetes and the way you can help them manage their diabetes.

Holly: You’re right because depression and diabetes are so commonly diagnosed in the same person that it’s hard for me to take the best care of them if I don’t know about all of the factors that could get in the way of them being healthy.

Eboni: What you’re saying is so important. I can imagine that family members and caregivers can play a big role in this as well.

Unlike us, they are the ones who see individuals with diabetes and can notice things that sometimes the patients themselves don’t notice.

If you could give some advice to patients and their caregivers about diabetes and depression, what would you tell them?

Holly: I’d tell them to not be afraid to be honest with their medical provider. I’d tell them that it’s ok to ask for help with managing the medical part or the mood/behavioral health part of diabetes.

I want them to ask for help! That’s how I can give them the best care.

What about you? What advice would you give?

Eboni: I would completely reiterate what you just said.

Another thing I’d mention is that it is normal for people to have both diabetes and depression.

And they are both treatable illnesses.

Both have shown good responses to medication management and behavioral interventions including therapy and improving lifestyle such as exercise and diet.

Holly: If you have other questions about whether or not you could have symptoms of depression in addition to your diagnosis of diabetes, make sure you let your medical provider know.

We want to know, and we want to partner with you in your journey toward wellness.