"Study sees major depression connection to diabetes" (Full Version)

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Vendaval -> "Study sees major depression connection to diabetes" (4/26/2007 2:44:33 AM)

"Study sees major depression connection to diabetes"

POSTED: 2:54 p.m. EDT, April 24, 2007

" WASHINGTON (Reuters) -- Elderly people who are depressed are more likely to become diabetic than those who are not, according to a study that suggests depression may play a role in causing the most common form of diabetes.

Writing on Monday in the Archives of Internal Medicine, the researchers said people with a high number of symptoms of depression were about 60 percent more likely to develop type 2 diabetes, formerly called adult-onset diabetes, than people not considered depressed.

Unlike some other studies examining a link between depression and diabetes, this one looked at the effects not only of single bouts of depression but also of chronic depression and depression that worsened over time. It found an increased risk for diabetes in each of those scenarios. "


http://www.cnn.com/2007/HEALTH/conditions/04/24/diabetes.depression.reut/index.html


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HutchGarahl -> RE: "Study sees major depression connection to diabetes" (4/26/2007 3:31:53 AM)

I always thought diabetes was a sugar problem. How can depression cause diabetes??? Depression ain't sugar. I'm gonna have to read this thing.



KatyLied -> RE: "Study sees major depression connection to diabetes" (4/26/2007 5:45:42 AM)

It's a study of ELDERLY people.



Royalton -> RE: "Study sees major depression connection to diabetes" (4/26/2007 9:42:02 PM)

These are my 2 cents:

Please all be aware that this study is looking for CONNECTION, not CAUSALITY.  Meaning that is not designed to try to find out if diabetes causes depression or visceversa, but how CORRELATED are diabetes and depression.

Being and elderly people study, most (if not all) cases of diabetes are going to be type 2.  Type 2 diabetes has a great chance of being prevented, or delayed, or controlled, or improved with lifestyle alone.  An active life, exercise, proper diet, weight management, can prevent, delay, control or improve diabetes type 2.

A person who suffers from depression has more chances of not having a healthy lifestyle, gains weight, is sedentary, eats anything, etc. etc.  Thus, if this person has a propensity for diabetes type 2, he or she has more chances of getting it.

On the other side, and elderly person who sees his or her life going down the drain because of health problems (i.e. diabetes type 2, being one of those) has more chances of becoming depressed because of loss of self esteem, lack of support, etc. etc.

I bet that there is a positive correlation between diabetes and depression (more people with diabetes tend to have depression and visceversa) 



DreamyLadySnow -> RE: "Study sees major depression connection to diabetes" (4/26/2007 10:22:52 PM)

When I'm depressed I eat a lot of sugar for the quick rush.
Too much sugar over too long can lead to diabetes.
Just a thought.

LS



KMsAngel -> RE: "Study sees major depression connection to diabetes" (4/27/2007 6:13:43 AM)

not just sugar. carbs and so forth break down to simple sugars. quick food also tends to be eaten - more fat in that, which also contributes. can turn into a vicious cycle: you eat the wrong foods and don't exercise properly - u gain weight - all this makes u more susceptible to diabetes

elderly people more at risk because of their changing phsyiology and more sedentary lifestyle, changed lifestyle, etc.

(sorry, doing nursing course at uni discussing this vy thing, lol)[:)]



Aswad -> RE: "Study sees major depression connection to diabetes" (4/27/2007 10:36:32 PM)

Quick reply here...

There is a positive correlation between diabetes and depression.

The professor that treated my depression is currently engaged in an ongoing study on the role of astroglial cells in depression, which was sparked from this correlation. Apparently, the astroglial cells are the ones that show abnormal metabolism in depression, and the only cells in your brain that respond to insulin, plus ISTR they mop up excess glucose. Not too long ago, these cells (who outnumber our neurons ten to one or so) were seen as largely irrelevant to how our brain works, but recently there has been a lot more research into them. We might be on the verge of another paradigm shift, which would be pretty exciting.

This can probably lead to some interesting developments, although I suspect no-one will bother to come up with any decent prognostic markers, or any good predictors for what kind of treatment will work best. Although the insurance companies will most likely come up with some "good enough" prognostic markers; their bottom line comes from the other side of the table, after all.




kazinja -> RE: "Study sees major depression connection to diabetes" (4/28/2007 5:55:08 AM)

The role of insulin in the astroglial cells in the central nervous system has been addressed in a study by Boutaddi published in Neurochemical Research in 1988. Sorry if it's a little technical; I'll try to keep it as simple as possible. [Glial cells are the cells that support, protect and nourish the neurons in the brain. There are different types of glial cells].

Many, if not all, neurons and glial cells of the brain have insulin receptors. In many of those cells, especially the stellate astrocyte subtype, GABA uptake is stimulated; however in other subclasses of astroglial cells, the uptake is reduced, even at extremely low levels of insulin. GABA is a potent neurotransmitter in mood regulation. Low levels of GABA are associated with depression.

A possible mechanism might be: Chronic stress is an importan risk factor in (the chronification of) depression (i.a. by cortisol dysregulation). GABA, by its inhibiting function, could reduce an overload of nerve simuli, and thereby counteract the effect of stress. Any mechanism that dysregulates the optimal levels of GABA in the brain could therefore be associated with depression. Diabetic or pre-diabetic people (which correlates well with 'the elderly') often have some level of insulin-resistance, which might disrupt the GABA balance. So by this mechnism the association insulin-GABA-depression could be explained quite straightforwardly.

Greetings!

K/R



Aswad -> RE: "Study sees major depression connection to diabetes" (5/3/2007 12:45:39 PM)

Greetings, kazinja.

quote:

ORIGINAL: kazinja

The role of insulin in the astroglial cells in the central nervous system has been addressed in a study by Boutaddi published in Neurochemical Research in 1988. Sorry if it's a little technical; I'll try to keep it as simple as possible. [Glial cells are the cells that support, protect and nourish the neurons in the brain. There are different types of glial cells].


No need to keep it simple. Do you have a more precise cite so I could go look it up on one of the sites that carry this publication?

quote:

Many, if not all, neurons and glial cells of the brain have insulin receptors.


As I recall, the neurons themselves don't have insulin receptors?

quote:

In many of those cells, especially the stellate astrocyte subtype, GABA uptake is stimulated; however in other subclasses of astroglial cells, the uptake is reduced, even at extremely low levels of insulin.


Is there any noted effect on the glutamate uptake, or just the GABA uptake?

quote:

GABA is a potent neurotransmitter in mood regulation. Low levels of GABA are associated with depression.


Well, roughly speaking, yes. Though, as I recall, only certain subtypes of depression are associated with low GABAergic activity, and I wouldn't be surprised if those correlate significantly with low ยต-opiergic (sp?) activity, indicating an upstream cause.

quote:

Chronic stress is an importan risk factor in (the chronification of) depression (i.a. by cortisol dysregulation).


The HPA-axis theory of depression was still rather controversial, last I checked, and my cortisol was fairly stable and normal for the decade-plus my own depression lasted. I'd agree that chronic stress can be a significant risk factor, but I'm not convinced that cortisol dysregulation is the only relevant pathway for this.

quote:

GABA, by its inhibiting function, could reduce an overload of nerve simuli, and thereby counteract the effect of stress.


Increasing GABAergic activity does reduce stress, as anyone who's taken benzos or barbs will attest to, but it doesn't necessarily reduce nerve stimuli. For instance, for me, phenobarbital is almost as stimulating as d-amfetamine, and I'm not alone in getting paradoxical disinhibition from diazepam. I'm thinking GABA, like dopamine, can also supress the function of certain "filter" circuits, leading to increased activity "downstream" from said circuits.

quote:

Any mechanism that dysregulates the optimal levels of GABA in the brain could therefore be associated with depression.


~nod~

quote:

Diabetic or pre-diabetic people (which correlates well with 'the elderly') often have some level of insulin-resistance, which might disrupt the GABA balance.


Yeah. Quite possible. I know a few people with insulin-resistance issues, and they tend to respond rather idiosyncratically to GABAergics.

quote:

So by this mechnism the association insulin-GABA-depression could be explained quite straightforwardly.


Somehow, I doubt it is quite that straight forward. It rarely is. [:D]

But, yeah, it seems like a credible sketch of what might happen in "diabetic depression" or whatever the buzzword will eventually be. The study I was talking about was looking at people with normal insulin-resistance, though. Looking forward to the publication, as the timing of the study kind of cost me 9 months of my life, so I might as well see what it was spent on. [:D]



kazinja -> RE: "Study sees major depression connection to diabetes" (5/4/2007 1:16:22 PM)

I was simply suggesting a possible explanation for the connection put forward by the OP. I am, like you Aswad, opposed to monocausal explanations and oversimplifications. I'm not trying to prove anything, just conveying some information to those interested. There are many types of depressions with even more causes, I do agree.
I am afraid I haven't the time to go into all the questions, but I cited the source of the information. After reading that, you know as much as I do.
I don't think there was mention about glutamate in the article and it did speak about insulin receptors on the neurons, I recall.

Greetings

K/R



juliaoceania -> RE: "Study sees major depression connection to diabetes" (5/6/2007 7:56:01 PM)

You know, I believe that depression can be majorly related to sugar intake. I have no trouble believing this study. If your body cannot regulate sugar this causes ups and downs in your moods, energy levels.

I was 225 when I was depressed, and I truly believe my diet (eating junk and drinking a lot of pepsi) contributed to it. How can a person feel good if they are malnourished?



Aswad -> RE: "Study sees major depression connection to diabetes" (5/8/2007 5:09:04 AM)

quote:

ORIGINAL: kazinja

I was simply suggesting a possible explanation for the connection put forward by the OP. I am, like you Aswad, opposed to monocausal explanations and oversimplifications.


It is certainly a possible and somewhat plausible explanation.

And I must say it's refreshing to see a medical professional that is opposed to monocausal explanations and oversimplifications, as I have all too often encountered professionals who either go entirely for that approach, or who see everything as too complicated to try reasoning about it, even when there are models that fit the data.

quote:

I'm not trying to prove anything, just conveying some information to those interested.


I certainly appreciate the information. Thank you.

quote:

There are many types of depressions with even more causes, I do agree.


Indeed. Not to get entirely off-topic, but have you seen the work done by Dr. Amen on the experimental use of SPECT imaging in diagnosing and treating mental health issues? I'm not entirely sure what I think of it, but it does seem like an interesting avenue to explore, and some of the subtypes of depression he has identified correlate with some of those I have identified using other methods. Interestingly enough, my findings about what kinds of depression respond to what kinds of medication appear congruent with his.

Of course, I'm not a professional, so I can't say for sure that I haven't just been lucky so far, and with the people I've been involved in treating, it's either been a matter of the docs asking me for advice based on prior experiences with me, or the patients asking for my advice and taking it to their docs. So far, I've been spot-on whenever I felt fairly certain, though, and have been in the right ballpark when I didn't feel all that certain, but this can all just be beginner's luck, of course.

quote:

I am afraid I haven't the time to go into all the questions, but I cited the source of the information. After reading that, you know as much as I do.


I'll see what I can find. Boutaddi and Neurochemical Research 1988 should be specific enough to dig it up, provided s/he didn't publish a lot that year.

quote:

I don't think there was mention about glutamate in the article and it did speak about insulin receptors on the neurons, I recall.


As far as I can recall, there aren't insulin receptors on the neurons themselves, only on the astroglial cells, but I could certainly be mistaken. I'll have a look at it if/when I find the article.

ISTR that astroglial cells are involved in glutamate regulation as well, though.



Aswad -> RE: "Study sees major depression connection to diabetes" (5/8/2007 5:20:05 AM)

quote:

ORIGINAL: juliaoceania

You know, I believe that depression can be majorly related to sugar intake. I have no trouble believing this study. If your body cannot regulate sugar this causes ups and downs in your moods, energy levels.


Sugar intake is somewhat a distinct topic, although still relevant. As I recall, there was something about sugar affecting the blood-brain barrier in some way, along with the more obvious effects.

In diabetes, however, the link might be the insulin receptors themselves. The study I was talking about deals with how metabolic disturbances and/or insulin receptor issues in the astroglial cells might be the cause of the shifts in brain activity observed in various kinds of depression. Basically, metabolic abnormalities are seen in the same areas that are involved in the depression.

quote:

I was 225 when I was depressed, and I truly believe my diet (eating junk and drinking a lot of pepsi) contributed to it. How can a person feel good if they are malnourished?


225 didn't make any sense without units. Years seems unlikely. Kilograms would be impressive if your avatar picture is yourself. Pounds make sense, but it'd still be useful with an idea whether that's the unit you have in mind; if so, neph would probably appreciate your comments on whether there were any problems with loose skin and/or stretchmarks upon returning to your current weight.

Sugar can definitely have an impact on depression, and we often see people "self-medicate" with sugar, even to the point of getting addicted. I've always been of the opinion that kids shouldn't be exposed to sugar until they reach the age where they have to acquire a taste for it if they want it, and have the health issues explained to them, so they'll have more of a choice in the matter.

However, you might also consider that there are other aspects of nutrition that are just as important. For instance, your dietary intake of l-tryptophan, l-phenylalanine, l-tyrosine, pyridoxine, pyridoxal, pyridoxamine, folic acid, selenium, methyl donors and so forth all have an effect on your mental health.

People who eat a lot of junk food, or who are vegans, may have trouble covering all of these; in those cases, it might make sense with prophylactic treatment with Emsam, supplementation or some other strategy to deal with the deficiency until they are able to change their habits.



juliaoceania -> RE: "Study sees major depression connection to diabetes" (5/8/2007 7:42:52 AM)

quote:

225 didn't make any sense without units. Years seems unlikely. Kilograms would be impressive if your avatar picture is yourself. Pounds make sense, but it'd still be useful with an idea whether that's the unit you have in mind; if so, neph would probably appreciate your comments on whether there were any problems with loose skin and/or stretchmarks upon returning to your current weight


I have no more loose skin than most women my age who have had children, and a lot less than some. I am very tall, nearly 6 foot. I also have a very strong body, so my largest size was between a 14/16 (american sizes), which is not obese. I am still losing. I weigh now about 5 lbs more than that picture. I follow a very healthy diet, and I want to lose about 20 lbs. My skin is going back as I lose slowly. I would say everyone is different though. The units I related were lbs, and that pic was taken after I lost 55 lbs

quote:

Sugar can definitely have an impact on depression, and we often see people "self-medicate" with sugar, even to the point of getting addicted. I've always been of the opinion that kids shouldn't be exposed to sugar until they reach the age where they have to acquire a taste for it if they want it, and have the health issues explained to them, so they'll have more of a choice in the matter.


Over exposure to empty simple carbs that convert to sugar, and sugar, cause insulin resistance. One can tell an insulin resistant person by how they put on weight as they age, and some initial symptoms. Insulin resistant people tend to gain weight in their upper body, while not gaining weight in their hips, buttocks, arms, legs. Insulin resistant people tend to have swings in emotions and moods and energy levels. They also will crave more sugar/empty carbohydrates in order to maintain blood sugar levels. Insulin resistant people will often develop type II diabetes. This disease runs in my family. I have one diabetic sibling, and another that is bordering on diabetic. I watch what I eat, I exercise, and I watch for signs that I maybe heading toward insulin resistance. I had some of those early signs, so I nipped it in the bud!

quote:

However, you might also consider that there are other aspects of nutrition that are just as important. For instance, your dietary intake of l-tryptophan, l-phenylalanine, l-tyrosine, pyridoxine, pyridoxal, pyridoxamine, folic acid, selenium, methyl donors and so forth all have an effect on your mental health.


I eat foods rich in these substances, such as sunflower seeds, turkey, cheese. I also take vitamin supplements. i am not a vegan. I find exercise and sitting in the sun also help.

quote:

People who eat a lot of junk food, or who are vegans, may have trouble covering all of these; in those cases, it might make sense with prophylactic treatment with Emsam, supplementation or some other strategy to deal with the deficiency until they are able to change their habits.



For people who eat a lot of junk, they probably need to adjust blood sugar levels by following a diet like South Beach, which will help keep blood sugar normal and insulin resistance in check, in addition to having proper nutrients








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