Q: I'm a diabetic, and lately, I've been experiencing some major mood swings. Could my diabetes be causing this, or do I have other issues?

Fluctuations in blood sugar levels can be associated with changes in mood. Usually this is seen with very high or low blood sugar levels. Mood swings are reported by a significant number of patients with diabetes. This not only affects the patients, but also their relationships at home and at work.

People living with a chronic disease, such as diabetes, are prone to anxiety and depression. Mood swings may be related to emotional inability to cope with stressors in life. Numerous studies have reported a two- to three-fold increased prevalence of depression among diabetics. People who have diabetes and untreated depression concurrently are more likely to have complications related to diabetes.

Good blood sugar control is the mainstay of diabetes care. People who have less swings in their blood sugar readings, are less likely to have mood changes. It is important for a patient to chart out a comprehensive treatment plan, with his or her care provider. Exercise and diet play a major role in blood sugar control. Studies have shown that exercise releases endorphins in the brain. These are chemicals responsible for mood elevation. Physical activity is increasingly becoming part of the prescription for the treatment of depression and anxiety.

Uncontrolled depression is a well known barrier to diabetes care. Patients should be open with their health care providers about their symptoms. A consult with a mental health professional may be advisable. Treatments range from psychotherapy to medications. Once the underlying mood disorder is treated, patients can then focus on their treatment regimen. There are numerous studies which show improvement in blood sugar control after successful management of the underlying behavioral disorder.

Arti Bhan, M. D., is a senior staff physician, Division of Endocrinology, Diabetes, Bone and Mineral Disorders, at Henry Ford Health System in Detroit.  She received her fellowship training in Endocrinology at Henry Ford, where she is currently involved in teaching residents and fellows. Her clinical interests include diabetes, thyroid disorders, and disorders of bone and mineral metabolism.