New Delhi: A study has found a two-way relationship between complications due to diabetes, such as heart attack and stroke, and mental health conditions, like anxiety and depression - having any of the problems from the former group increased the risk of one from the latter, and the other way round.
Researchers said that the two-way link could also be "less direct" as both -- diabetes complications and mental health conditions -- shared multiple risk factors, including obesity and problems in controlling blood sugar levels, which increase the chances of developing both sets of disorders.
"Most likely, a combination of direct and indirect effects and shared risk factors drive the association we are seeing," Maya Watanabe, a biostatistician at the Harvard University's School of Public Health, US, and first author of the study published in the journal Diabetes Care, said.
"Diabetes care providers may be able to simultaneously prevent the risk of multiple complications by providing interventions to treat these shared risk factors," Watanabe said.
For the study, the researchers examined insurance claims made from 2001 to 2018 data from over five lakh people with type 1 or type 2 diabetes and more than 3.5 lakh people without diabetes.
The authors found that people having a chronic diabetes complication had a two-fold or three-fold higher risk of developing a mental health condition, while those having mental health disorders were found to be up to 2.5 times more likely to experience sustained diabetes complications.
"We found a consistent bidirectional association between chronic diabetes complications and mental health disorders across the life span, highlighting the important relationship between (both sets of conditions). Prevention and treatment of either comorbidity may help reduce the risk of developing the other," the authors wrote.
Further, "in those (of) age less than 60 years, individuals with type 1 diabetes were more likely to have chronic diabetes complications, whereas individuals with type 2 diabetes were more likely to have mental health disorders," they wrote.
A possible reason for this bi-directional relationship may be that having a diabetes complication or a mental health condition has direct effects on developing the other disorder, the researchers said.
"For instance, a stroke causes detrimental effects on the brain, which may directly lead to depression," senior author Brian Callaghan, a professor of neurology at the University of Michigan, US, said.
"And having a mental health condition and diabetes may affect a person's self-management of their condition -- like poor glycemic control or not taking medications -- which, in turn, may increase their risk of diabetes complications," Callaghan said.