الفهرس 
The bi-directional relationship between depression and Type 2 DMOnly 14 pages are availabe for public view
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Abstract
The concurrence of depression and diabetes is a serious problem. Among
people with diabetes, whose risk of depression is 50–100% greater than the
general population;depression is associated with higher complication and
mortality rates. Moreover, depression may impair control of glycemia and
treatment compliance, as well as increasing the risk of vascular complications
indiabetes.
On the other hand, the response to antidepressants has been reported to be
altered in diabetics. A report at the annual meeting of the American Psychiatric
Association indicated that the total burden of cardiovascular risk factors in a
patient with major depressive disorder is an independent predictor of lack of
response to antidepressant therapy with fluoxetine.
Treatment with antidepressants has also been reported to affect glucose
homeostasis in diabetic individuals. Although diabetes risk is elevated for the
major antidepressant classes, the risks posed by individual medications may
vary widely. Indeed, several studies indicated that the effect of selective
serotonin reuptake inhibitors (SSRIs) on glycemic control is quite controversial.
Long-term treatment with paroxetine and fluvoxamine has been reported to
carry an increased diabetes risk while elevated risk was not associated with
long-term use of fluoxetine, citalopram, or sertraline. In contrast, a
hypoglycemic effect was reported by a study involving fluoxetine or paroxetine
while other studies failed to confirm this finding and still others noted a
worsening of glycemic control.