الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Diabetes mellitus (DM) is one of the most frequent chronic diseases worldwide, being among the top five main causes of death in developed countries. This endocrine disease is also becoming epidemic in developing countries. Type 2 diabetes mellitus (T2DM) is the most prevalent form of the disease, representing 90% to 95% of cases.T2DM is a chronic disease characterized by hyperglycemia as a result of inadequate response to production of insulin by the pancreas. This occurs due to insulin resistance to the insulin-producing β cells in the islets of Langerhans which occur in genetically susceptible individuals by environmental factors.The natural history of T2DM has been well described in multiple populations. Individuals destined to develop T2DM inherit a set of genes from their parents that make their tissues resistant to insulin. In liver, the insulin resistance is manifested by an overproduction of glucose during the basal state despite the presence of fasting hyper insulinemia and an impaired suppression of hepatic glucose production (HGP) in response to insulin, as occurs following a meal. In muscle, the insulin resistance is manifest by impaired glucose uptake following ingestion of a carbohydrate meal and results in postprandial hyperglycemia. Although the origin of the insulin resistance can be traced to their genetic background.Maintaining an appropriate glycemic control is important to prevent long term complications of diabetes, such as retinopathy, nephropathy and neuropathy. Despite the growing knowledge about behaviors that might improve glycemic control, many persons do not follow the treatment recommendation. Different emotional problems might complicate the required self-management of the disease, and limit the persons’ management of self-care activities necessary to achieve an adequate glycemic control.Depression is one of the emotional problems associated with diabetes and it is considered as a modifiable risk factor whose treatment could improve glycemic control and health outcomes in patients with T2DM. Depression is a state characterized by low mood and unwillingness to participate in any activity that can affect a person’s thoughts, attitude, and sense of well-being. An association between depression and diabetes is well-known and was recognized when Thomas Willis (a British physician) noted that diabetes frequently appeared in individuals with previous experience of life stresses or sadness. Now the prevalence of depression in patients with TIDM or T2DM is about twice that of the non-diabetics. There is growing evidence regarding the bidirectional adverse interaction between diabetes and depression. Depressive symptoms are associated with loose glycemic control and increased risk of diabetic complications; reciprocally, poor glycemic control and functional impairment due to the diabetes complications may cause or worsen depression and decrease response to antidepressant treatment