الفهرس 
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Abstract
The concurrence of depression and diabetes is a serious problem. Among individuals with diabetes, the risk of depression is 50–100% more than the general population; depression is allied with higher morbidity and mortality rates. Additionally, depression may impair control of glycemia and adherence to treatment, as well as increasing the risk of mico- and macrovascular complications in diabetes.
Meanwhile, the response to antidepressants has been reported to be altered in diabetic patients. Treatment with antidepressants has also been reported to affect glucose homeostasis in diabetic individuals. Although diabetes risk is elevated for the major antidepressant classes, the risks posed by individual medications may vary widely. The benefits of tricyclic antidepressants for depression in patients without other major medical problems are well-established, but the efficacy of any antidepressant agent for depression in diabetic patients remains unproven.
Indeed, several studies indicated that the effect of selective serotonin reuptake inhibitors (SSRIs) on glycemic control is quite controversial. Long-term treatment with paroxetine and fluvoxamine has been reported to carry an increased diabetes risk while elevated risk was not associated with long-term use of fluoxetine, citalopram, or sertraline. In contrast, a hypoglycemic effect was reported by a study involving fluoxetine or paroxetine while other studies failed to confirm this finding and still others noted a worsening of glycemic control. Although, successful treatment of depression in diabetes may have positive effects on both mood and glucose regulation because of their observed relationship yet, this possibility has not been studied systematically. Successful treatment of depression in diabetes may have positive effects on both mood and glucose regulation because of their observed relationship, but this possibility has not been studied systematically.
Several attempts to investigate the neurobiology and the pathophysiology of depression in diabetes to find the correlation between them and to measure antidepressant effects of drugs used in diabetes. Furthermore, there is no sufficient data about their effect and further investigation is needed.