Do you ever notice why people who are suffering from Diabetes have other severe disorders like Depression, Hypertension, Obesity and Diabetic Peripheral Neuropathy???? No??  Because Diabetes is a disorder which becomes the stimulus (etiology) for other disorders like Depression and Diabetic Neuropathy.

Therefore, it’s a high time we talk about the 3D’s – Diabetes, Depression and Diabetic Neuropathy.

These 3D’s are interlinked with one another, that is Diabetes may lead to Depression and Depression may lead to Diabetes- through a bi-directional pathway, in the same way, Diabetes may also cause Diabetic Neuropathies that is if the patient is suffering from diabetes than he/she may have a higher probability to suffer from comorbid conditions like Depression and Diabetic Neuropathy.

The story of the 3D’s is not rare, as the pathophysiological comorbid incidence and prevalence of diabetes –  Depression and Diabetic Neuropathy are very high around the globe.

3D’s – Diabetes:

According to the “International Diabetes Federation”, in 2015, about 415 Million people in the world were diagnosed to have Diabetes and by the end of 2040, this will increase to 642 million. Every 6th second, 1 person dies from Diabetes.

Pakistan has seen dramatic increases in rates of Diabetes prevalence and incidences over the recent years. There were over 7 million cases of diabetes in Pakistan in 2015, but these are only reported numbers, there is a much more high prevalence of undiagnosed patients of Diabetes in Pakistan.

3D’s – Depression:

Depression is another alarming disorder and is on the rise, Depression is a common mental disorder. Globally, an estimated 350 million people of all ages suffer from Depression, Depression is the leading cause of disability worldwide and is a major contributor to the overall global burden of disease.

According to BMJ, “In Pakistan, one in three people are anxious or depressed”

If a patient is suffering from Depression, then he may have compromised the overall quality of life because a depressed patient may become isolated, suffer from a lack of social interaction, does not stick to a healthy lifestyle like maintaining a healthy diet, exercise, and drugs treatment and also adopt unhealthy behavior like smoking. These all elements are the precursor of diabetes and its complications like Diabetic Neuropathy.

3D’s – Diabetic Neuropathy:

Diabetic neuropathy is also a horrible disorder, Diabetic peripheral neuropathy is nerve damage that is caused by chronically high blood sugar. Diabetes neuropathy leads to numbness, loss of sensation, and sometimes pain in feet, legs, or hands.

It is the most common complication of diabetes. In general population, there is no recognition of Neuropathy as disorders as they take it as a general numbness, and then there’s the bitter truth that society is still under the impression that Diabetic Neuropathies are just a myth. In our society, there is a misleading concept that tingling and numbness in fingers and toes are due to lack of oxygen or RBCs in blood, which is a false belief.

People who never suffered from neuropathies have no idea about the intensity of neuropathic pain and its consequences in daily life. The person who never suffered from Neuropathy, they just take Neuropathy pain as normal pain, however, in Diabetic Neuropathic Pain, patients have severe pain and worse impact on quality of sleep because his bed of roses turned into a bed of thorns after this disorder.

Hence we can say that the 3D’s– Diabetes, Depression, and Diabetic Neuropathy have the tri-directional pathophysiological pathway in developing these disorders. By taking control of Diabetes we can take control of Depression and Diabetic Neuropathy.

Below are the tips by which, we can avoid these 3D’s
10 Simple lifestyle measures have been shown to be effective in preventing the 3D’s:

1)      Take a healthy diet (fruits and vegetables) and an appropriate amount of drinking water

2)      Avoid sugar and saturated fats

3)      Take your meals on time

4)      Make it a habit of regular physical activity and exercise plus also maintain normal body weight

5)      Avoid tobacco use (Smoking)

6)      Be socially active – Spend time with your family and friends

7)      Get enough sleep

8)      Work with a positive attitude and approach

9)      Take your medication on time

And last but not the least.

10)   BE HAPPY AND SPREAD HAPPINESS