Depression is a risk factor for diabetes and diabetes is a factor for causing depression. The symbiotic relationship is complicated and can be seen as an opportunity for the medical community to consider how messaging is targeting a more privileged population. Reflect for a moment and consider the impact having ‘just a touch” or “borderline” diabetes descriptions could have on your patients. Offered as a way to ease fears and worry, the unintended consequences minimize a person’s experiences which feels invalidating and fail to express how diabetes is tied to other conditions, including heart disease, hypertension, and risk of depression which, by the way, is increased by a factor of two in patients with diabetes. Studies have documented the interdependence of depression/diabetes as contributing to poor patient engagement, adherence to medication and dietary regimens, glycemic control, reduced quality of life, and of course, increased health expenditures. The expense of depression and diabetes was calculated in a 2016 study with the overall mean medical expenditures for patients with diabetes and no depression was $10,016, unrecognized depression was $15,155, asymptomatic depression was $16,134, and symptomatic depression was $20,105. This study looked narrowly at depression and didn’t factor in how the Social Determinants of Health (SDoH) have a similar symbiotic relationship with diabetes.