IMPACT OF DIABETES MELLITUS ON THE SEVERITY OF DEPRESSION: A NARRATIVE REVIEW

Diabetes mellitus and depression are highly prevalent chronic conditions that frequently coexist and significantly worsen patient outcomes when present together. Growing evidence indicates that individuals with diabetes not only experience a higher prevalence of depression but also exhibit greater severity of depressive symptoms compared with the general population. This narrative review summarizes current evidence on the impact of diabetes mellitus on the severity of depression, with particular emphasis on depression severity scores, glycemic control, disease duration, diabetes-related complications, and behavioral and psychosocial factors. Biological mechanisms such as chronic hyperglycemia, inflammation, hypothalamic–pituitary–adrenal axis dysregulation, and insulin resistance, along with psychosocial stressors and treatment burden, appear to contribute to more severe and persistent depressive symptoms in people with diabetes. The bidirectional relationship between poor glycemic control and depression severity further complicates clinical management. Understanding this interaction highlights the importance of early screening, integrated metabolic and mental health care, and multidisciplinary interventions to improve both psychological and glycemic outcomes in patients with diabetes.