Key concepts in screening for depression in people with diabetes
J Affect Disord. 2012 Oct;142 Suppl:S72-9
Holt RI, van der Feltz-Cornelis CM
Abstract
BACKGROUND: The prevalence of depression is increased in people with diabetes and there are both national and international recommendations for screening of depression in people with diabetes. The aim of this review is to assess the justification for screening for depression in people with diabetes.
METHODS: The viability, effectiveness and appropriateness of screening for depression in people with diabetes were assessed based on the UK National Screening Committee criteria for appraising screening programs. For this purpose, a review of relevant publications from the literature listed in MEDLINE, Psych-INFO and EMBASE was performed.
RESULTS: Most criteria for screening of depression in diabetes are fully or partially fulfilled. Further research is needed to provide fully scientifically substantiated recommendations for screening for depression in diabetes, especially in the areas of effectiveness and cost-effectiveness of such screening programs.
LIMITATIONS: As most screening is currently sporadic and there are no formal screening programs, some criteria are not satisfied.
CONCLUSIONS: There is a rationale to introduce screening for depression in patients with diabetes in a clinical setting but further research is needed to evaluate the most clinically effective and cost effective way of doing so in structured screening programs.
PMID: 23062860
Depression is the outcome of multiple underlying pathologies leading to a proinflammatory state. Diabetes is in part a proinflammatory illness. The other pathologies in diabetes also predispose the patient to an increase in proinflammatory signaling. This is why it is important to screen for diabetes in patient who present with depression.
The tests for diabetes generally include:
– fasting insulin – the most sensitive for detecting insulin resistance
– hemoglobin A1c
– fasting glucose
– lipid profile with triglycerides and HDL cholesterol.
Additional helpful tests include:
– cortisol AM
– reverse T3
– etc.