KOCHI: Despite being one of the most common chronic illnesses in India, Type 2 Diabetes Mellitus (T2DM) is often discussed only in terms of blood sugar control, diet, and medication.
Yet, beneath the surface, an equally critical factor silently influences patient outcomes — mental health. A recent study by my centre, Metnoia NewHealth Diabetes and Lifestyle Diseases Research Institute, uncovered alarmingly high levels of depression, anxiety, and stress in patients with uncontrolled diabetes, even when they exhibit no outward symptoms.
The findings point to a hidden crisis, one that demands urgent attention from healthcare providers, families, and policymakers. The study has been accepted for publication in the International Journal of Diabetes and Technology.
A research team headed by psychologist Nova K focused on 65 individuals, 34 men and 31 women aged between 45 and 60 years.
All participants had elevated HbA1c levels, a clear indicator of poor long-term glycaemic control.
None reported mental health problems, but we suspected there might be more beneath the surface.
This is one of the first prevalence studies of its kind in Kerala, focusing specifically on asymptomatic diabetic patients.
The team used the Depression, Anxiety, and Stress Scale (DASS-21) to measure psychological well-being, alongside standard blood tests. The data was striking:
30% of patients had severe depression
25% experienced severe anxiety
15% reported severe stress
Many were dealing with more than one of these conditions simultaneously. When we compared the results with HbA1c levels, the link was unmistakable — those with higher psychological distress consistently had poorer blood sugar control. This was not simply a coincidence; it was a warning.
What this means is clear: mental health plays a critical role in diabetes management. Ignoring it can make controlling the disease far more difficult, even for patients who appear physically stable.
What needs to be done
Integrate routine mental health screening into the care of patients with uncontrolled diabetes, regardless of whether they report emotional symptoms. Tools such as DASS-21 are efficient, validated, and easy to implement in any clinical setting.
India’s diabetes burden is growing at an alarming rate, and the hidden mental health crisis that accompanies it could quietly undermine treatment efforts. By recognising the mind and body as interconnected systems, we have a better chance of improving not just numbers on a lab report, but the lives of the people behind them.
Mind and body
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The writer is founder of Metnoia NewHealth Diabetes and Lifestyle Diseases Research Institute in Kochi.