[Depression--an important obstruction to the treatment of diabetes]

In diabetics, depressive states represent a major impediment to treatment. This applies equally to persons with depressive mood (subclinical) and patients with clinically manifest depression. Particular consideration should be given to the possibility of depression in patients with emotional problems associated with the disease, recurrent episodes of severe hypoglycemia, and sequelae. The diagnosis is relatively easy to establish with the aid of a structured talk or an easy-to-complete questionnaire. Discussing the problem with the patient and referring him/her to a teaching program may be the first step towards treating the depression. When considering medication, possible side effects and interactions with diabetic therapy must be taken into account.