The 3Ds Dilemma- (Diabetes-Depression-Diabetic Neuropathy)

By: Dr. Muhammad Umair khan


These 3Ds ‘Diabetes, Depression and Diabetic Neuropathy’, are interlinked with one another, where Diabetes may leads to Depression, Depression may leads to Diabetes, and Diabetes may also cause Diabetic Neuropathies. Therefore, it’s a need of time to talk about 3Ds.

Do you ever notice that why people who are suffering from Diabetes have other severe disorders like Depression, Hypertension, Obesity and Diabetic Peripheral Neuropathy????


Because Diabetes is a disorder which becomes the stimulus (etiology) for other disorders like Depression and Diabetic Neuropathy.

Therefore, it’s a need of time to talk about 3Ds– Diabetes, Depression and Diabetic Neuropathy.
These 3Ds are interlinked with one another that is Diabetes may leads to Depression and Depression may leads 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 more probability to suffer from comorbid conditions like Depression and Diabetic Neuropathy.

The story of 3Ds is not rare, as the pathophysiological co-morbid incidence and prevalence of diabetes- Depression and Diabetic Neuropathy is very high around the globe.

3Ds- Diabetes:

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

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

3Ds– 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, than he may have compromised overall quality of life because a depressed patient may become isolated, lack of social interaction, do not stick to healthy life style like 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.

3Ds – Diabetic Neuropathy:

Diabetic neuropathy is also a horrible disorder, Diabetic peripheral neuropathy is nerve damage 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 they take is as general numbness, and there is  bitter truth that society is still in myth regarding Diabetic Neuropathies. In our society there is a misleading concept that tingling and numbness in fingers and toes is due to lack of oxygen or RBCs in blood, which is false believe.

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 bed of thrones after this disorder.

Hence we can say that, 3Ds– Diabetes, Depression and Diabetic Neuropathy has tri-directional pathophysiological path way 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 this 3Ds– (Diabetes, Depression and Diabetic Neuropathy)
10 Simple lifestyle measures have been shown to be effective in preventing 3Ds (Diabetes, Depression and Diabetic Neuropathy)

  • Take healthy diet (fruits and vegetables) and appropriate amount of drinking water
  • Avoid sugar and saturated fats
  • Take your meals on time
  • Make habit of regular physical activity and exercise plus also maintain normal body weights
  • Avoid tobacco use (Smoking)
  • Be socially active- Spend time with your family and friends
  • Get enough sleep
  • Work with positive attitude and approach
  • Take your medication on time

And last but not the least.


The writer is a pharmacist by profession.


About Social and Development log of Pakistan (SDLP)

Social and Development log of Pakistan (SDLP) is an attempt to highlights real public issues, which include social, economic and political issues, and complete policy analysis of that issues having experts opinion and analysis on it. SDLP will raise all public issues on the basis of facts and figures and try to advocate at highest forum which may influence the policy makers and draw their attentions towards real problem. SDLP also welcome to those who want to contribute on our blog at For that you may send your queries/suggestions/articles etc at Twitter: or @rajataimur786 Facebook:
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