Depression and anxiety are twice as likely to plague people with diabetes (search), the CDC reports. Many live in poverty, with poor health, and get little health care — even though counseling and medications could improve their mental outlook.

Their 2003 study is based on a community health telephone survey involving nearly 10,000 adults living in New York City. Interviews were conducted in 23 languages.

Of the 9,590 adults surveyed, 9 percent had diabetes. Of those with diabetes, 10 percent also had serious emotional distress, including depression (search). The survey showed that people with diabetes were almost twice as likely as those without diabetes to have serious psychological distress.

Among people with both diabetes and emotional problems:

—49 percent were divorced, separated, or widowed compared with 25 percent of people with diabetes only

—70 percent had incomes under $25,000 vs. 43 percent of people with diabetes only

—11 percent had private insurance compared with 41 percent with diabetes only

—42 percent cited cost as reason for not getting a prescription filled or not seeing a doctor vs. only 16 percent of people with diabetes only

—26 percent used emergency departments as their usual source of health care — that's more than twice that of people with diabetes only (10 percent)

Also, those with both conditions were:

—Nearly twice as likely to report fair or poor health (78 percent compared with 40 percent of the diabetes-only group)

—Three times more likely to say poor health limited their activities (64 percent compared with 22 percent in the diabetes-only group)

—Seven times more likely to report limitations in daily activities due to their poor mental health (63 percent compared with 9 percent in the diabetes-only group)

Previous diabetes studies have indicated similar findings — that depression occurs twice as often among people with diabetes as in the general population, write the study’s researchers.

Other studies have shown, too, that people facing both diabetes and depression don’t always get treatment for their emotional distress — even though both medications and counseling have been shown to help.

With the extra burden of financial and insurance problems, these people face serious difficulties in getting good health care, the researchers write. More research is needed to determine the best methods to improve their clinical depression, they note.

By Jeanie Lerche Davis, reviewed Brunilda Nazario, MD

SOURCE: CDC, MMWR, Nov. 26, 2004; vol 53: pp 1089-1092.