I remember the endocrinologist who diagnosed my diabetes told me there wasn't one body part that wasn't affected by the disease. It also seems the body parts that exist furthest from one another are linked when it comes to diabetes.

The June 2007 issue of Diabetes Care published the results of a recent study out of Britain in which 253 diabetics with their first foot ulcer were assessed for depression. One-third of them suffered from clinical depression; 24.1 percent had major depressive disorder and 8.1 percent had minor depression. Eighteen months later, there had been 40 deaths, 36 amputations, and 99 recurrences of ulcer. Those who were considered depressed were found to be three times more likely to have died.

The study did not indicate whether the subjects were depressed about their foot ulcer, having diabetes, or something else altogether.

Sleep disorders have been linked to exacerbating or even precipitating diabetes as well as depression. Poor sleep robs people of their health in general. But, for diabetics it can cause a worsening of their condition. A hypnotist can assist a person with diabetes by helping them to positively alter their behavior.

A study explained how people who do not get enough sleep on a regular basis tend to become less sensitive to insulin over time. The study found that healthy adults who averaged 5.2 hours of sleep a night secreted 50% more insulin than their more rested counterparts, who averaged 8 hours of sleep a night. As a result, "short sleepers" were 40% less sensitive to insulin.

Devin Hastings is a certified hypnotist who has been helping people change their lives for over 24 years. Devin has created a series of informative articles that will help diabetics transform their debilitating habits into healthier habits. See Devin's site for more details.

Self-report studies are known for sometimes being inaccurate, chiefly because too much responsibility is placed on the respondents. Oftentimes people forget, overestimate, underestimate or do a host of other things that result in partially or wholly inaccurate reporting. There's also something known as The Testing Effect; a situation wherein people answer a question a particular way because they feel it is the answer the test-giver is looking for. So, in sum, self-report studies aren't really the best source for data collection. I mention all of this because it was a self-report study that researchers recently used to link symptoms of depression with the development of diabetes in older adults.

Researchers from Northwestern University studied a group of over 4,600 participants who were at least 65 years of age or older and did not have diabetes at the outset of the experiment in 1989. Each year for ten years, the participants were evaluated for symptoms of depression, based on the participants' response to survey questions. Also recorded each year were clinical measures that would indicate the development of diabetes.

The researchers found that as the participants reported feelings of depression as the years went on, an increase in participants who developed diabetes occurred.

Now, aside from the problems related to the self-report study, I also wonder how the researchers can be so sure that the depression lead to the diabetes. In fact, it seems to make more sense (at least to me) that the diabetes led to the depression. A person contracting a life-altering disease such as diabetes certainly wouldn't add joy to their life, so it stands to reason that it would instead make them a bit -- if not very -- depressed. I'm no scientist, but this correlation seems to make much more sense to me.

Scientists have studied the effects of stress on glucose levels in animals and people. Diabetic mice under physical or mental stress have elevated glucose levels. And now, as if the aforementioned isn't bad enough - researchers have found that a single socially stressful situation contributes to depression in rats.

It seems this single socially stressful scenario is killing new nerve cells in the hippocampus, the area of the brain that processes learning, memory and emotion. In young rats, the stress of encountering older, aggressive rats didn't stop the creation of new brain nerve cells. It prevented the new nerve cells from surviving, which left the young rats with fewer neurons for processing feelings and emotions. Researchers anticipate that this impact on neurogenesis could be a cause of depression. The next step in this discovery is to correlate an effective plan of treatment to preserve the healthy development of nerve cells from the hippocampus.

The timing of this Washing Post article and the topic of Lissa Coffey's latest Coffeytalk newsletter seemed to harmonize splendidly. Lissa is a lifestyle expert who offers interpersonal advice based on ancient wisdom eloquently packaged in modern style. Her latest piece of advice went out to a friend of hers that was feeling social friction from the other people at work. Her friend loved the job but wanted to feel more connected with the rest of her coworkers. Lissa advised her friend: be the dog. She continues..."go in and be the dog. Open that door with a big smile on your face, tail wagging, full of enthusiasm! Look at how dogs win people over just by being themselves, by being happy and comfortable right where they are. Be the dog." Great advice, Lissa!! I'd also like to thank Bean Bag for taking a moment out of her busy watchdog schedule to smile for the camera.

Remember that movie with Billy Crystal and Robert De Niro, Analyze This? Well we all don't have super-risky mobster lifestyles to induce depression like Paul Vitti's, but according to a new study of depressed type 2 diabetics -- depression has a negative impact on blood sugar control.

Researchers treated 93 patients with type 2 diabetes and depression with the antidepressant bupropion (Wellbutrin). They chose the drug because it is capable of reducing depression and weight simultaneously. The hypothesis behind the treatment was mood enhancement and weight reduction would, in fact, improve blood sugar control. (Always a gold star day in my book!) The results were documented in the March issue of Diabetes Care, and showed that antidepressant treatment produced benefits beyond just mood improvement. Patients also lost weight, improved self-management of their diabetes, and improved their A1c levels.

In the 6 months following the conclusion of the study, depression improvement predicted maintenance of improved blood sugar control. This confirms the research hypothesis that depression improvement can produce better blood sugar control, independent of weight loss and overall diabetes management. The importance of weight-independent physiological factors like insulin sensitivity and inflammation improve during depression relief and contribute to better long-term control of diabetes.

The moral of this story? You tell me. I spotlight the research - I like it when you guys give me answers.

And now for the best headline of the week, courtesy of The Australian: STATE OF MAN: FAT AND DEPRESSED. Ouch. I see the the stereotypical image of Australian men starting to crumble. In the 80s we had Mel Gibson in his heyday. In the 90s we got Russell Crowe. And now, this??

Yes, according to a new study, the "disease burden" in Australia is behind the decline of the Australian man. The study found that half of Aussie men aged between thirty-five and eighty years of age have officially tipped the scales into that dreaded category called Overweight. A further thirty percent are even worse off - in the Obese category. That leaves just a minority, twenty percent, of a normal weight. Yikes, that is bad!

The culprit, as is so often the case here in the US, is the unhealthy lifestyle led by so many. Lack of exercise and poor eating habits lead to weight gain and further inactivity. Not to mention diabetes. Sixteen percent of the Australian men in this study have Type 2 diabetes. Other big problems are depression, anxiety, and asthma. All evidence of a trend that researcher Gary Wittert characterizes as "alarming" and links to social causes like lack of social standing, low earning potential and relationship dissatisfaction.

Mel, you're having problems, that's true. But take heart! Looks like you have plenty of company...or would if you would only return to your homeland. (Just a suggestion...)

Please excuse the editorial nature of this piece. I often post about the scientific studies about diabetes. Today I'd like to discuss a bizarre thought I've had about the management of diabetes and how eerily similar I feel it is to a phenomenon known as cutting. I preface this blog with a sincere apology for anyone that is offended by the comparison. I know all too much about diabetes and very little about cutting, but my curiosity led me to read a little more about it and I remain stymied by the similarities.

Diabetes is controlled by repeated checks of blood glucose. The most effective way of measuring blood glucose is to prick your finger, draw blood, and drop it into a machine to read the results. This must be done anywhere between 2 and 12 or more times a day. Once the results are given - a diabetic should a) take insulin by injection or an insulin pump or an oral medication b) eat something or c) do nothing. The objective of drawing blood is to know your numbers. Ultimately this will ensure you are in range. That's right - test, treat and repeat. This routine, if followed religiously throughout your life, will best divert any long-term complications associated with diabetes. No guarantees.

A cutter is someone who practices self-injury (also known as self-harm and self-mutilation) by scratching or cutting his or her skin with a sharp object. Cutting is usually a symptom of mental illness and most often is used as a coping mechanism. By no means is this a symptom to ignore. It is serious and often implies a more serious underlying condition that warrants serious medical attention.

The necessary roughness of drawing blood serves a purpose for both diabetics and cutters. Of course one is medically supervised to care for the well-being of an individual and the other is self-inflicted and harmful for the individual. The end result of incessantly checking blood sugars will result in better control of a life-threatening disease. The end result of cutting is a scar reminding the cutter of a deeper pain. Both causes of the behavior are nonetheless tragic. As a type I diabetic, I do everything I can to avoid having to be reminded of diabetes - even if that requires me taking breaks from my life to test, treat, and repeat. I appreciate the perspective of anyone who wishes to share about the control regimen of their diabetes, or the psychology of a cutter.

The results of this study do not surprise me at all. Researchers have found that psychosocial factors like cynical distrust, chronic stress and depression, may be associated with higher levels of inflammatory markers. These inflammatory markers are related to an increased risk for cardiovascular disease, the leading cause of premature death among people with diabetes.

The study included 6,814 men and women between the ages of 45 to 84. Participants were assessed for their levels of depression, chronic stress and cynical distrust. Blood samples obtained at the start of the study were analyzed for markers for inflammation. The researchers found associations between all three psychosocial factors and inflammatory markers.

A high stress lifestyle may increase the chance that an individual engages in social behaviors that increase inflammatory markers. The same high stress lifestyle may contribute to obesity and related metabolic problems. Furthermore, socioeconomic position is likely to be a precursor to psychosocial characteristics. True. But let's not wager our lives on a dollar-denominated scale. Consider the Chinese proverb, those who know when they have enough are rich. Now ask yourself where you stand in the socioeconomic parade. If you put it that way - I'm on easy street! Too bad it's in the wrong neighborhood.

Researchers found that using a systematic approach for the treatment of depression in diabetics will not increase health care spending, and might actually decrease the overall costs.

Researchers evaluated the cost and cost-effectiveness of a systematic depression treatment program versus the usual care for 329 outpatients with diabetes and depression. The intervention involved specialized nurses who provided a 12-month stepped-care depression treatment program using psychotherapy or antidepressant drugs or both. Systematic depression treatment significantly reduced the patients' average depression scores after 6 and 12 months, and these improvements were maintained at 24 months.

Outpatient depression treatment costs were approximately $700 higher in the intervention group during the first year, the results indicate. However the general medical outpatient costs in this group were lower, and offset most of the difference. During the second year, the approximately $100 in higher outpatient depression treatment costs in the intervention group was more than offset by lower outpatient costs of approximately $1400.

The study was designed with the hope of alleviating human suffering caused by diabetes. If reducing the burden of suffering also reduces costs of care, then depression management programs should be routinely integrated into diabetes care. Preempt this mission with the fact that the systematic depression treatment programs were associated with an increase of 61 depression-free days and an estimated cost savings of $300 - that's a monthly stipend of 20% more Happy Days and a half tank of gas. That'll give you something to smile about!

A study shows that men with type 2 diabetes experience pronounced risk of erectile dysfunction (ED) when they have symptoms of depression.

Depression appears to be a vicious cycle that may instigate the development of ED, while the ED symptoms perpetuate the symptoms of depression. Effectively deducing that ED in diabetic patients is not related entirely to organic factors. The study evaluated men with type 2 diabetes who completed questionnaires every 6 months for 3 years. Five hundred men reported ED at the start of the study, and an additional 192 developed the disorder during follow-up. The investigators noted higher prevalence of high blood pressure (46% versus 32%) and lipid abnormalities (23% versus 13%) among men who complained of ED. The researchers also observed higher incidence of retinopathy, neuropathy or heart and vascular disease in ED sufferers. Those with ED were more likely to be treated with insulin or diuretics. Depression and ED was found more often in those with poor physical and psychological health.

The researchers surmised that erectile problems are not necessarily an inevitable outcome of the aging process. The risk factors for ED are modifiable and can be changed to reduce the likelihood of the outcome (or lack thereof). The results should serve as uplifting news for suffers of ED, no pun intended.

Does this sound familiar? Weight Gain? Memory Lapses? Mood Swings? Fatigue? The Sugar Solution is an easy-to-follow, drug-free program that can bring blood sugar into balance in just one month. Weight gain, fatigue, depression, and poor concentration are symptoms that could potentially lead to diabetes, heart disease and cancer.

The book points out that high blood sugar and depression often go hand in hand. In fact, depression may lead to increased sugar consumption and ultimately depression. The Sugar Solution helps readers determine whether they're at risk for blood sugar problems and shows them how to keep their blood sugar levels in range without drugs or injections. The exclusive 30-day lifestyle makeover guides them every step of the way, with complete daily menus, exercise strategies, and stress-reduction techniques. Pounds will melt away, energy will soar, and mental sharpness will return as blood sugar stabilizes.

The book will be helpful for people looking for an exercise and eating plan to help stabilize blood sugar levels and lose weight. Kick-off the New Year with a new approach to a better lifestyle!

A study outlined in the American Journal of Clinical Nutrition examined the psychosocial consequences of weight reduction, asking the question -- how much weight loss is enough?

The psychosocial effects of weight reduction showed an association with improvements in mood in significantly obese individuals who are treated by diet and lifestyle modification. Exercise is associated with modest but long-term weight losses and with improvements in mood and physical health. The recommendation that overweight Americans lose weight should be prefaced with efforts to promote healthier attitudes toward weight and shape. A 10% reduction in initial weight correlates with improvements in psychosocial functioning. Even patients with just a 5% reduction in body weight report improvements in mood. They feel better as a result of taking charge of their eating and exercise habits and, ultimately, their weight.

As a footnote: please don't read this blog and walk-away thinking the message is lose some weight, Fatty. I'm a self-professed Pork Chop in hot pursuit of a dopamine deluge. I know when I'm surging with happiness, food is the furthest thing from my mind. I'm looking for the map to this euphoric destination. The minute I find it-- you'll have directions, too!

A man by the name of Mike Adams, also known as the Health Ranger, compares the addictive nature of table sugar to that of illegal drugs like crack and heroin in a comic named Sugar Addicts. Mike explains how white sugar is like dietary crack. Believe me when I tell you, this is only a taste of how passionately he shares his crusade on information that empowers^TM.

Mike created News Target after a life altering experience. Before the age of 30, he was struggling with borderline obesity, diabetes, depression and severe back pain. Visiting doctors and following their advice enabled him to continue to eat anything he wanted, until he had an epiphany. He realized that practically everything he was led to believe about health, disease, food and medicine is possibly untrue. So began his mission of educating people on how to achieve and maintain peak health. Mike shares his discoveries about harmful foods, drugs, medical practices and dishonest marketing, to defend our ability to have a healthy future.

Call him a prophet of self-help, if you will. Mike shares his super-learning abilities with us. He knows, firsthand, that when you reform your physical health, you are revitalizing your entire nervous system - including your brain. With this highly perceptive clarity, he continues to educate us with articles that embody his own experience of health transformation. He has made it his life's work to explore and share the truth about nutrition, disease, health and healing. He features a quote from the Dalai Lama that sums it up, "Our prime purpose in this life is to help others. And if you can't help them, at least don't hurt them." Hear, hear, Mr. Lama.

Researchers from the Joslin Diabetes Center in Boston have completed a study of elderly diabetes patients. Their findings show that those patients with poorly controlled blood sugar are more likely to experience cognitive difficulties. Functional disabilities and depression also occur at higher rates in these patients.

Okay, this was not a huge study. It involved just sixty diabetics, all of whom were over seventy years of age. They all had diabetes and poorly controlled blood sugar. More than a third of the patients got low scores on standard drawing tests and scored similarly low on the Mini Mental State Examination test. Thirty-three percent exhibited symptoms of depression and had greater than average difficulty in completing basic daily tasks.

The results of the study have been published in Diabetes Care (August 2006). The researchers involved in the study recommend doctors screen elderly diabetic patients for cognitive dysfunction, depression and other disabilities because the presence of such conditions directly (and negatively) impact their ability to manage blood sugar control.

Those delicious late night snackies may be bad for you. Researchers at the University of Washington in Seattle say that diabetics who eat lots of food in the evening are upping their risk of health complications. These experts sat down and interviewed 714 diabetes patients about their eating habits. Ten percent said they ate more than one-quarter of their daily food intake not at dinnertime, but after dinnertime. That means snacking after dinner, and getting up at night (even multiple times in the night) to sneak some late-night food treats - and we're not talking apples and oranges here. No, we're talking about snacks of the fatty and highly processed variety - the kinds of foods that give nutrition experts the night frights.

Seems that this little habit catches up with these patients in their declining health - they were two to three times more likely than the other patients in the study to be obese, to have poor blood sugar control or to have multiple diabetes-related complications, including the "biggies" - heart disease, and kidney and nerve problems. The cause? It seems that these patients are more likely than others to be suffering from depression. It appears that the late night eating is a coping mechanism. Researchers hope that access to therapy and antidepressants could help these people out.

The results of the study have been published in Diabetes Care (August 2006).