Diabetes and Depression: from Iranian Traditional Medicine to Modern Literature

BACKGROUND Diabetes is a common chronic disease that is characterized by impaired insulin secretion and insulin resistance. It is considered an urgent public-health issue because of its epidemic perspective. Depression is a highly prevalent disease with a lifetime prevalence of 17%. Individuals with depression experience reduced functioning and decreased quality of life. Psychiatric disorders frequently occur in type 2 DM patients and about 15% of the diabetic patients are susceptible to depression. In Iranian traditional medicine (ITM), the relationship between diabetes and depression is mentioned and special attention to their psychiatric problems is considered in the treatment of diabetes. METHODS This study is a descriptive review according to available Iranian traditional medicine literature such as Canon compared with modern medicine by using PubMed and Scopus databases. RESULTS In ITM, diabetes is divided into warm and cold categories where the warm type is more common. Emotions such as anger and grief can play an important role in creating the warm or cold diabetes, respectively. In modern medicine, several studies found that the odds of depression in the diabetic group were more than the non-diabetic comparison group. On the other hand, depressed mood was associated with an increase of developing type 2 diabetes. Depression may have a role in the pathogenesis of DM with stimulation of the hypothalamic-pituitary-adrenal axis, which results in increased cortical level and blood glucose, eventually progressing to diabetes. CONCLUSION Evidence in modern medicine suggests that diabetes and depression can be a risk or exacerbating factor to each other. In ITM, the theory of association between depression and diabetes is more highlighted than modern medicine, which is mentioned since more than 1000 years ago. It seems that emphasis on the treatment of depression in diabetic patients may have significant effects in the course of their disease.