[Depression in patients with type 2 diabetes mellitus--clinical and therapeutical implications]

The prevalence of depression is three times greater in people with type 2 diabetes than in the general population. In these patients, the course of this disease is more severe, the duration of therapy is longer and the rate of recurrent relapses is higher. Diabetes mellitus often occurs in the patients with previously diagnosed depression, and also diabetics being in the course of therapy used to be affected with depression. A special correlation was pointed at between complications diabetes such as macroangiopathy, retinopathy, polyneuropathy and incidence of depression. The coincidence of these diseases can be the cause of deterioration of diabetes. Treating these patients often require psychotherapy or both pharmacotherapy and psychotherapy. Selective serotonin reuptake inhibitors (SSRI) are the drugs of choice in the pharmacological treatment of depression. These drugs contribute to lowering the level of glycaemia, lowering the rate of HbA1c, increasing the sensitivity to insulin and they improve cognitive functions. Except decreasing libido they do not cause arrhythmias, hypotonia, urine retention or disturbances of emptying the stomach.