A study published in Pediatric Diabetes examined depression in adolescents with type 1 and type 2 diabetes.

Researchers looked at 149 teens and young adults with diabetes. They screened the patients for health and depression using both the Patient Health Questionnaire and the PROMIS Pediatric Global Health scale. Within this group, 7.4 percent had clinically significant depressive symptoms. 

Higher levels of depression in type 2 youths

The results showed that those with type 2 had much higher scores of depressive symptoms than those with type 1. In addition, the link between global health and symptoms of depression was stronger in youths with type 2 diabetes. 

The length of time someone had diabetes made no difference in those with type 1, but was associated with greater depressive symptoms in youths with type 2. On the other hand, among those with better overall health, adolescents with type 1 had more depressive symptoms. There was no difference based on gender.

Study implications

Health providers should use varying methods for treating depression in T1D and T2D youths. Psychologists should look at each person’s diabetes type and overall health to see how best to treat their symptoms. 

“Providers caring for adolescents with diabetes may consider evaluating depressive symptoms among youths with generally low health status and, as time passes, following a type 2 diabetes diagnosis,” said Jessie J. Wong, Ph.D., study leader and instructor at Stanford University.

“Depression-focused interventions for adolescents with diabetes may be tailored to address overall health for youths with type 1 and type 2 diabetes and target factors associated with longer diabetes duration among adolescents with type 2 diabetes.”

Depression and diabetes

Much research has been devoted to the connection between depression and diabetes. 

People with type 2 are two to three times more likely to have depression than those who do not. In addition, people with depression are more likely to develop diabetes. Researchers have been looking into whether this is biological or due to emotional and lifestyle factors.

One possible biological culprit is brain insulin resistance, which happens when the cells of the brain are unable to respond to insulin.  

Research in Psychiatry Advisor has  outlined the connections between brain insulin resistance and depression. 

Brain insulin resistance

Brain insulin resistance affects:

• The brain’s reward center, which in turn influences
  • Depression
  • Reward-seeking behaviors
  • Obesity
  • Diabetes
  • Anhedonia (inability to experience pleasure) 
• The brain’s response to stress
• The brain’s centers for emotional processing, decision making, learning, and memory – which has been shown to be significant for youths with high insulin resistance (type 2 diabetes)

In relation to this, there are new uses of drugs that help with insulin resistance that might also benefit depression, such as:

• Intranasal insulin. Inhalable insulin has been linked to better mood and memory improvement. Plus, it’s absorbed quickly and it doesn’t involve an injection.  
• Liraglutide (Victoza). An injectable that helps insulin to work better in the body. 
• Metformin. This common diabetes drug affects the mitochondria that regulate cellular energy.
• Drugs that augment insulin (rosiglitazone, pioglitazone).  

More research is needed to be sure each of these treatments are effective and safe, especially in youths and adolescents. 

Other proven treatments for depression with diabetes are cognitive behavior therapy, healthy eating, and regular exercise.