NEW DELHI: Are you diabetic? If yes, you are at an increased risk of suffering from depression. According to experts, diabetes doubles the risk of depression compared to those without the disorder. In fact, at present, 30%-60% of diabetics living in India are suffering from mild to acute depression.

Still, depression is not listed as a complication arising out of diabetes. What's worse, physicians presently treating diabetics let depression go undiagnosed and untreated.

According to professor of psychiatry S Malhotra from PGI, Chandigarh, what physicians fail to understand is depression directly interferes with the treatment of diabetes as depressed people tend to eat more and exercise less, which results in weight gain and sabotages efforts at controlling blood-sugar levels.

They also miss their daily medication. Malhotra told TOI: "If physicians treat depression, controlling diabetes will become much simpler. Even a mild depression will interfere gravely with diabetes management of the patient."

According to diabetes expert A K Jhingan, 60% of those suffering from depression due to diabetes are women. "Studies showed constant feeling of fatigue, urinary infections due to blood sugar, and medicines made women, mostly above 40 years, depressed," he said. Depression develops because of the metabolic effects of diabetes on the brain.

Many newly-diagnosed diabetics go through stages like denial, anger, depression and acceptance. Wild oscillation of blood sugar, either going above 300 or below 50, leads to acute mood swings, sadness and irritability.

At present, physicians treating Type 1 diabetes in children are always accompanied by psychiatrists. However, when treating adults, this is totally ignored.

"Because of physiological and behavioral interactions between diabetes and depression, each becomes more difficult to control, increasing the risks of cardiovascular disease, diabetic retinopathy causing blindness and neuropathy. Physicians must immediately start checking diabetics for depression.

Treating one without treating the other is impossible," experts added. In people who have diabetes and depression, experts say psychotherapy and antidepressant medications have positive effects on both mood and glycemic control.

However, trials are being carried out to understand the link between depression and diabetes and the behavioral mechanisms by which improvement in depression fosters better adherence to diabetes treatment.