Depression + diabetes = increased risk of death

Abstract image of depression

Depression is a growing problem in our society, and diabetes has reached epidemic proportions.
Major depressive disorder affects nearly 15 million American adults – that’s almost 7% of the adult population, and it is the leading cause of disability in the U.S. for individuals aged 15-44. [1] Type 2 diabetes affects almost 10% of Americans, about 24 million people, and is the 7th leading cause of death in the U.S. [2]

In women, it has been shown that those with depression are more likely to develop diabetes, and those with diabetes are more likely to develop clinical depression.[3] Diabetes doubles the risk of heart attack and stroke, and depression is also an independent risk factor for heart disease, increasing risk by 64%. [2, 4] A new study has found that the coexistence of depression and diabetes imposes additive detrimental effects, especially with regard to death from cardiovascular disease. As a part of the Nurses’ Health Study, 78,000 women were followed for 6 years, and diagnoses of depression and type 2 diabetes were recorded.


Compared to subjects with neither diabetes nor depression:

  • Depression alone increased risk of all-cause mortality by 53%, and cardiovascular mortality by 56%
  • Diabetes alone increased risk of all-cause mortality by 52%, and cardiovascular mortality by 146%
  • The risk of death from all causes climbed in those with both conditions to more than double, and risk of cardiovascular mortality almost quadruple that of individuals with neither condition.
  • Those who had lived with diabetes for more than ten years combined with depression more than tripled their risk of death from cardiovascular disease.
  • Depressed individuals who were also on insulin therapy had almost 5 times the risk of death from cardiovascular disease.[5, 6]

This is a reminder not only of the substantial health hazards associated with diabetes, but also the significance of the mind-body connection – in this study, depression increased the risk of death from all causes by 53%. Psychological conditions profoundly affect physical health. The potential physiological effects of depression on the cardiovascular system include increased platelet aggregation and inflammation, sympathetic nervous system hyperactivity, and impaired endothelial function. [7] Living healthfully, with the right lifestyle and diet-style in conjunction with judicious use of supplements to assure comprehensive nutritional adequacy can go a long way to making sure you and your loved ones avoid both diabetes and depression.

No one needs to resign to becoming a victim of these common American conditions.

Even if you have or have had depression, there are effective natural methods for getting well. Dr. Fuhrman uses a treatment regimen that includes morning light therapy and exercise combined with a high nutrient diet and supplementation with vitamin D and omega-3 fatty acids for patients with depression. Type 2 diabetes is a disease of poor lifestyle choices. As such, health-promoting lifestyle habits – a high-nutrient diet and exercise – are established in the medical literature as effective treatments for diabetes. [8-13] Furthermore, a high-nutrient, vegetable-based diet offers dramatic results as it unlocks the body’s enormous healing potential, enabling many people to completely reverse their diabetes. Living a healthy lifestyle allows you to take control of your own health – both physical and mental health.



1. The Numbers Count: Mental Disorders in America.
2. American Diabetes Association: Diabetes statistics. Available from:
3. Pan, A., et al., Bidirectional association between depression and type 2 diabetes mellitus in women. Arch Intern Med, 2010. 170(21): p. 1884-91.
4. Wulsin, L.R. and B.M. Singal, Do depressive symptoms increase the risk for the onset of coronary disease? A systematic quantitative review. Psychosom Med, 2003. 65(2): p. 201-10.
5. Pan, A., et al., Increased mortality risk in women with depression and diabetes mellitus. Arch Gen Psychiatry, 2011. 68(1): p. 42-50.
6. Walsh, N. Depression Plus Diabetes Raises CV Death Risk. Medpage Today, 2011.
7. Huffman, J.C., C.M. Celano, and J.L. Januzzi, The relationship between depression, anxiety, and cardiovascular outcomes in patients with acute coronary syndromes. Neuropsychiatr Dis Treat, 2010. 6: p. 123-36.
8. Barnard, N.D., et al., A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial. Am J Clin Nutr, 2009. 89(5): p. 1588S-1596S.
9. Barnard, N.D., et al., A low-fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes. Diabetes Care, 2006. 29(8): p. 1777-83.
10. Barnard, N.D., et al., Vegetarian and vegan diets in type 2 diabetes management. Nutr Rev, 2009. 67(5): p. 255-63.
11. Trapp, C.B. and N.D. Barnard, Usefulness of vegetarian and vegan diets for treating type 2 diabetes. Curr Diab Rep, 2010. 10(2): p. 152-8.
12. Thomas, D.E., E.J. Elliott, and G.A. Naughton, Exercise for type 2 diabetes mellitus. Cochrane Database Syst Rev, 2006. 3: p. CD002968.
13. Conn, V.S., et al., Metabolic effects of interventions to increase exercise in adults with type 2 diabetes. Diabetologia, 2007. 50(5): p. 913-21.


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Comments (3) Read through and enter the discussion with the form at the end
Ryanna - January 10, 2011 1:42 PM

I wish I could agree completely with the simplicity of the statements above regarding depression, and especially with the quote "no one in America needs to resign to becoming a victim of these two diseases"... However, I would like to re-iterate that although the "solutions" suggested above may help, they do not prevent depression or constitute a treatment in themselves.

In the case of light therapy for example, self-administering the treatment is more complicated then indicated in Furhman's papers, and can lead to other mental and physiological problems. Therefore, it is recommended that someone who shows signs of depression sees a specialist. Unfortunately, depression, especially major depression requires tremendous energy, resources, and support to treat, and is a disease for which successful treatments still need more studies.

In many cases, a lack of key resources -- especially financial support, poor understanding of the disease on the part of sufferers, families and sometimes even specialists, as well as lack of follow up from specialists, prevent many sufferers from achieving good self care, and, ultimately, recovery.

I do not think that the situation in America is hopeless, but it is most definitely serious. Mental health needs to be recognized on the same level as physiological health by health care providers, insurance providers, and governmental entities in order for prevention and treatment to be truly accessible to majority of sufferers.

thank you for reading.

Theresa Anderson - January 10, 2011 10:15 PM

Again, we see how a person is a whole unit. The mind being really powerful to affect the body for good or ill.

When we exercise, eat right, build our knowledge base, lose the chronic disease we automatically raise our joy factor.
When a high nutrient dense diet is used for our health, it also brings health to the brain. When a person feels empowered to help themselves with scientifically backed lifestyle measures, they can then gain a toehold on their ascent out of not only depression, but also debilitating disease. While some depressed individuals need professional care, all depressed people would greatly benefit by eating a diet that is rich in nutrients, moving more and getting the proper supplements. Diet and lifestyle are not the only defense, but should be the first defense.

Karrie - January 13, 2011 1:43 AM

I agree that the blog post is a bit simplistic. I have struggled with depression for almost 20 years and I've chosen to manage it through therapy, medication, diet and nutrition, and exercise. It's a complicated illness, and no one approach works alone or for everyone.

It is a treatable illness and I am glad that healthy eating has improved my life in many ways. I encourage everyone who is suffering from to depression to seek medical advice and treatment. There is hope

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