Depression. updated 11/2019

 

       In this 2016 study, patients with brittle diabetes show no differences in terms of global severity of psychopathological distress and specific symptoms of axis I DSM-IV-TR psychiatric diagnoses in comparison with subjects without brittle diabetes. Axis ! includes depression and anxiety formerly thought to be a cause of brittle diabetes. Personality traits such as histrionics and narcissistic tendencies were higher in the BT1D group. AS a result of these findings, BDF has eliminated depression as a cause of BT1D.

Compare this to the past:

It is appalling to find the lack of discipline in some of the “opinion” papers reviewed for this article. In one 1996 paper, the authors openly state that there is a “problem with our data”, that defining brittle diabetes is difficult and necessarily “somewhat subjective” , and that the data obtained on perceived causes of brittleness “is of course unsubstantiated and speculative”[1].  Why was this paper ever accepted for publication?

 

What is even more disturbing is that this paper is repeatedly cited by those who hold to the concept that behavioral attitudes lead to patient non-compliance which, in their thinking, accounts for the brittle condition - a rapid uncontrolled shifting, up and down, in blood glucose levels.  

This 1996 paper was written in an era when the relationship between depression and diabetes, particularly brittle diabetes, was viewed as unidirectional, and little if anything was understood about potential cause(s) of brittleness. Over the last decade, research into the relationship between diabetes and depression has begun to provide better insight into what most researchers today see as an association between these two chronic illnesses.  According to Nebergall  [2], the term association “means only that far more of the factors were found together than could be explained by random happenstance. It doesn’t mean you’re nuts”.

 

In BDF's opinion, the evidence is inadequate to accept  a causal relationship and prefers the use of association although the term “causal” is commonly employed in the literature.  If you accept the medical definition for complication then both these chronic diseases may serve in the minds of some researchers,  as a complication of the other. But the latest findings cited above do not support this conclusion. 

 

 

Bibliography

  1. G.V. Gill, S. Lucas and L.A. Kent.  Prevalence and Characteristics of Brittle Diabetes in Britain . 1996. QJM (1996) 89 (11): 839-84

  2. Peter J. Nebergall Depression and Diabetes.  http:// nfb.org/Images/nfb/publications/vod/  vsum007.html

Brittle Diabetes Foundation Inc.

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