Diabetes and depression in Africa: Causality, relationship and clinical implications

The public health threats posed by diabetes and depression individually have been well emphasised globally. However, it is increasingly important to understand these diseases' causes, relationships, and implications in comorbid states. Depression, anxiety, and diabetes are the top 10 causes of disability-adjusted life years (DALYs) in countries worldwide. Several reports have also suggested depression to occur two to three times more frequently in people with diabetes mellitus; with the majority of the cases remaining under-diagnosed, the causes and relationship remain rather complex and understudied. Although the exact link between depression and diabetes is yet to be detailed, quite a number of studies have supported that there is a bidirectional relationship between diabetes and depression. As Pieces of evidence, theories and reports continue to shed more light on the cause and relationship between these two conditions, its implications remain understudied, especially in low-middle-income settings. This commentary draws out the need for intentional screening for depressive symptoms in diabetic patients as early as possible from the implications of its neglect. It is, however, recommended that in the management of diabetes mellitus, emphasis should also be placed on depression as a co-morbidity, just as certain other disease conditions like hypertension and dyslipidaemia are considered.