In this episode, which has been recorded for Chronic Conditions Month 2021, Dr Peter Bagshaw (Clinical Lead in Dementia and Mental Health, South Gloucestershire CCG) and Dr Kevin Fernando (GP Partner at North Berwick Health Centre and Education Director for GPnotebook Education) discuss the interplay between diabetes and severe mental illness (SMI). What exactly is meant by SMI? How prevalent is mental illness in people with diabetes? What is the role of the gut–brain axis? What signs should clinicians be looking out for in spotting depression?