Targeting the link between diabetes and depression

By DAN KEGLEY/Staff

A campaign is on here and in the other end of the state to break the vicious circle of diabetes and depression, and to offer the hope for a better life that treatment of both disorders can bring.
Diabetes doubles the risk of depression, according to the Virginia Department of Health. It also increases the risk of type 2 diabetes, especially among women over the age of 45 and minorities. Moreover, VDH said, people who are depressed may not take care of their diabetes-related needs.
Southwest Virginia and the Eastern Shore, where diabetes rates are high, are the target areas of a VDH campaign to alert residents about what it calls “the debilitating link between diabetes and depression.”
“The good news is that there are effective treatments for both diabetes and depression,” said State Health Commissioner Karen Remley, M.D., MBA, FAAP.  “It is essential that people with these diseases be treated for both.”
In the Mount Rogers Health District, which includes Bristol, Galax and the counties of Bland, Carroll, Grayson, Smyth, Washington and Wythe, 12.3 percent of the population is diabetic. Additionally, 32.6 deaths per 100,000 deaths are diabetes related, according to VDH statistics.
In the Lenowisco Health District—Norton and the counties of Lee, Scott and Wise—the rate is 14.2 percent. And the Eastern Shore Health District of Accomack and Northampton counties has the most diabetic population, with 15.4 percent afflicted.
By contrast, statewide in Virginia the rate of diabetes among adults is 6.9 percent, meaning that about 400,000 Virginia adults have been diagnosed. Another 198,000 have the disease but don’t know it, VDH said.
VDH is in its second month of a pilot project to increase awareness of the diabetes/depression link and to increase the number of women who are screened and treated for both diseases.
Health workers have hand-delivered information kits, consumer posters and client information cards to approximately 200 medical and mental health professionals in three areas of the state with exceedingly high numbers of adults with diabetes, VDH said.
Radio stations in the areas have been offered a public service announcement on the issue. State health officials have developed a Web site (http://www.YouCanVA.com) to link professionals and residents to more information about diabetes and depression.
This is the content of the 30-second radio spot sent to local stations, according to VHD Southwest Regional Public Information Officer Robert Parker in Christiansburg: “Here is important health information for women over 45. If you have diabetes, you are twice as likely to be depressed. And if you have depression, you are at high risk of developing diabetes. When you are depressed, you may not take care of your diabetes like you should. But both diseases can and should be treated. Visit http://www.vdh.virginia.gov and talk to your doctor today. Make the connection between diabetes and depression. A message from the Virginia Department of Health.”
This campaign comes as health care professionals have seen the incidence of diabetes double in Virginia in 13 years as the result of a combination of factors.
“The rate in 1995 was 3.9 percent of adults,” said Ann Forburger, project manager for the Diabetes Prevention and Control Project at VDH. In 2006, she said, the rate was 7.4 percent.
In addition to more older and more overweight people, Forburger said more screening also is a factor. People are being identified who in the past might have gone undiagnosed.
Some direct costs of diabetes care include medications, insulin supplies, physician visits, glasses, special orthopedic shoes, hospital care, nursing home care, and surgery.
Nationwide, the American Diabetes Association said in January an estimated 17.5 million Americans have diabetes, costing an estimated $174 billion in medical and other costs, such as missed days from work, in 2007. That report updated a 2003 report that put diabetes costs at $132 billion.
To reduce diabetes, health care providers are identifying people who have pre-diabetes.
Pre-diabetes occurs “when blood sugar is not high enough to be diabetes, but higher than normal,” Forburger explained. It is not inevitable that those folks will develop diabetes, she said.
Proven prevention includes exercising 30 minutes a day at least five times a week, reducing body weight 5 to 7 percent, and eating a healthier diet.
“Even if you delay it 10 years, that is 10 more years not living with the disease and the potential complications down the road,” she said.
To screen for pre-diabetes, a person’s blood sugar level is measured after they have not eaten for at least eight hours.
“As fasting glucose levels go up, risk for diabetes goes up,” said Dr. John N. Clore, a diabetes expert at VCU Medical Center. “It’s a moment when lifestyle modification can make such a huge impact.”
VDH officials hope the diabetes/depression awareness campaign can bring those life-impacting moments to more people.
“Everyone has been very receptive to the campaign,” said Nancy Pribble, coordinator of VDH’s Diabetes Prevention and Control Project. “That’s encouraging because anyone who has diabetes and depression should be treated for both diseases.”
The campaign funding will end in August, Parker said Monday. But the effort will not end then.
“The resources on the campaign’s Web page will continue to be available to health professionals and consumers indefinitely,” Parker said.

Tammie Smith, Media General News Service, contributed.