Managing Depression in People With Diabetes

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Managing Depression in People With Diabetes

It’s long been known that a link exists between diabetes and depression — as Diane Fennell noted in a blog post here at a few years ago, research suggests that people with either condition are at higher risk for developing the other one. About 1 in 4 people with diabetes will be diagnosed with depression at some point in their lives, and women with diabetes who take insulin are as much as 53% more likely to develop depression than women without diabetes. But despite how common depression is — especially in people with diabetes — it still remains underdiagnosed and undertreated in the United States, as we noted here at Diabetes Flashpoints a few years ago.

But as two new studies show, there are effective ways to screen for, and to treat, depression in people with diabetes. The first study, on treating depression in people with Type 2 diabetes, was presented last month at the American Diabetes Association’s 77th Scientific Sessions in San Diego. As noted in a Medscape article on the study, researchers assigned 140 participants — residents of Indiana, Ohio, or West Virginia with major depressive disorder — to one of four groups. The exercise group followed a specialized program for 12 weeks that included six classes led by personal trainers. The cognitive behavioral therapy group received 10 one-on-one sessions with a licensed therapist. The combination group underwent both treatment programs, and the control group received no treatment other than seeing their regular doctor.

The researchers found that all three treatment groups were dramatically more likely to improve than the control group by the end of the study. Members of the cognitive behavioral therapy group were 12.6 times as likely as the control group to achieve partial or full remission of their depression, while members of the exercise group were 5.8 times as likely to achieve this. In addition to these depression-related outcomes, members of the combination group who started the study with an HbA1c level (a measure of long-term blood glucose control) of at least 7% saw their level drop by an average of 0.7% — an improvement large enough to be considered clinically meaningful.

The second study, on screening for depression, was presented last month at the American Association of Nurse Practitioners (AANP) 2017 National Conference in Philadelphia. As noted in an article on the study at Endocrinology Advisor, researchers set out to develop a protocol for screening adults with Type 2 diabetes. Based on a review of 10 studies, the researchers found that there was a significant association between depression and inadequate blood glucose control, as well as that diagnosis and treatment of depression led to improved HbA1c levels. They recommended that people with diabetes complete a questionnaire to screen for depression, which would be followed by another questionnaire and other data collection from people who scored positive for depression on the first questionnaire.

What do you make of these two studies — do you think all people with diabetes should be screened for depression? Have you ever experienced depression, either before or after your diabetes diagnosis? If so, did you try exercise or cognitive behavioral therapy to treat it, and was this treatment helpful? Have you noticed any correlation between symptoms of depression and your blood glucose control? Leave a comment below!

Want to learn more about diabetes and depression? Read “What Is Depression?” “Diabetes Distress and Depression,” and “Depression: Not a Normal Part of Aging.”

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