Depression and Diabetes

Ciechanowski, Paul; Katon, Wayne; Russo, Joan

doi:10.1001/archinte.160.21.3278

Cited by 1,217 publications

(315 citation statements)

References 47 publications

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“…43 Depressed diabetes patients have been shown to be less likely to adhere to dietary recommendations and oral diabetes medications, and less often engage in regular physical activity compared to non-depressed diabetes patients. 44, 45 …”

Section: Discussionmentioning

confidence: 99%

Keys to Successful Diabetes Self-management for Uninsured Patients: Social Support, Observational Learning, and Turning Points: A Safety Net Providers' Strategic Alliance Study

Madden

Tomsik

Terchek

et al. 2011

Journal of the National Medical Association

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Objective To determine how medically uninsured patients with limited material resources successfully manage diabetes. Methods Clinicians at 5 safety net practices enrolled uninsured adult patients (N=26) with prior diagnosis of diabetes for 6 months or longer. Patients were interviewed about enabling factors, motivations, resources, and barriers. Chart reviews and clinician surveys supplemented interview data. Interview, survey, and chart review data were analyzed and findings were summarized. Results Two distinct groups of patients were investigated: 1) “successful,” defined as those with an HbA1c of ≤7% or a recent improvement of at least 2% (n=17); and 2) “unsuccessful,” defined as patients with HbA1c of ≥9% (n=9) without recent improvement. In comparison to unsuccessful patients, successful patients more often reported having friends or family with diabetes, sought information about the disease, used evidence-based self-management strategies, held an accurate perception of their own disease control, and experienced “turning point” events that motivated increased efforts in disease management. Conclusions Uninsured safety net patients who successfully managed diabetes learned from friends and family with diabetes and leveraged disease-related events into motivational turning points. It may be beneficial for clinicians to incorporate social learning and motivational enhancement into diabetes interventions to increase patients’ motivation for improved levels of self-management.

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Section: Discussionmentioning

confidence: 99%

Keys to Successful Diabetes Self-management for Uninsured Patients: Social Support, Observational Learning, and Turning Points: A Safety Net Providers' Strategic Alliance Study

Madden

Tomsik

Terchek

et al. 2011

Journal of the National Medical Association

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“…Depression in diabetes is associated with low quality of life (3), impaired glycemic control (3), increased frequency of complications (4,5,6), and all-cause mortality (6). Depressive symptoms are associated with poor diet (3,7,8), smoking habits (9), less exercise (7), low adherence to medication (3,7,8), and higher health care costs (3,8). There are suggested overlapping biological links between depression and autoimmune diabetes indicated by high levels of circulating cytokines associated with both conditions, insulin deficiency impairing neurogenesis and neurotransmitter metabolism, a chronic hyperglycemic state and hypoglycemia episodes, and hyperactivity of the hypothalamic-pituitary-adrenal axis.…”

Section: Introductionmentioning

confidence: 99%

Depression, obesity, and smoking were independently associated with inadequate glycemic control in patients with type 1 diabetes

Melin

Thunander

Svensson³

et al. 2013

European Journal of Endocrinology

129

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Objective: The aim of this study was to explore the associations between inadequate glycemic control of diabetes and psychological, anthropometric, and lifestyle variables in a population-based cohort of type 1 diabetes patients. Design: Cross-sectional study. Methods: In this study, 292 patients with type 1 diabetes, aged 18-59 years, participated. Psychological data were assessed by self-report instruments: Hospital Anxiety and Depression Scale and Toronto Alexithymia Scale-20. Anthropometrics, blood analyses, data from medical records, and data from the Swedish National Diabetes Registry were collected. Results: Self-reported depression (adjusted odds ratio (AOR) 4.8), obesity (AOR 4.3), and smoking (AOR 3.0) were independently associated with inadequate glycemic control of diabetes (HbA1cO8.6%). Gender-stratified analyses showed that self-reported depression (AOR 19.8) and obesity (AOR 7.0) in women and smoking in men (AOR 4.2) were associated with HbA1cO8.6%. Alexithymia, antidepressant medication, and physical inactivity were associated with HbA1cO8.6% only in bivariate analyses. Alexithymia, self-rated anxiety, physical inactivity, and absence of abdominal obesity were associated with self-reported depression. Conclusions: Depression was the only psychological factor independently associated with HbA1cO 8.6%. The association was of comparable importance as obesity and smoking, well-known risk factors for inadequate glycemic control and diabetes complications. The association between depression and HbA1cO8.6% was particularly strong for women. Alexithymia, which is a relatively stable personality trait, was associated with depression. In the future care of patients with diabetes, psychological aspects should be considered alongside anthropometrics and lifestyle factors in order to achieve the goals for HbA1c.

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“…Compared to patients with diabetes alone, patients with depression and diabetes have poorer self-management (i.e. adherence to diet, exercise regimen and blood glucose monitoring) and significantly more lapses in refilling oral hypoglycaemic, lipid-lowering and antihypertensive prescriptions [3,4]. They are also significantly more likely to have cardiac risk factors such as smoking, obesity and sedentary lifestyle [5].…”

Section: Introductionmentioning

confidence: 99%

Does treatment of subsyndromal depression improve depression and diabetes related outcomes: protocol for a randomised controlled comparison of psycho-education, physical exercise and treatment as usual

Pibernik-Okanović

Ajduković

Lovrenčić

et al. 2011

Trials

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BackgroundThe prevalence of mood difficulties in persons with diabetes is approximately twice that in the general population, affecting the health outcomes and patients' quality of life in an undesirable way. Although subsyndromal depression is an important predictor of a more serious clinical depression, it is often overlooked. This study aims to compare the effects of two non-pharmacological interventions for subsyndromal depression, psychoeducation and physical exercise, with diabetes treatment as usual on mood- and diabetes-related outcomes.Methods and DesignType 2 diabetic patients aged 18-65 yrs. who report mood difficulties and the related need for help in a mail survey will be potential participants. After giving informed consent, they will be randomly assigned to one of the three groups (psychoeducation, physical activity, treatment as usual). Depressive symptoms, diabetes distress, health-related quality of life and diabetes self-care activities will be assessed at baseline, at 6 weeks, 6 months and 12 months. A structured clinical interview for DSM-IV Axis I Disorders (SCID-I) will be performed at baseline and at one-year follow-up in order to determine the clinical significance of the patients' depressive symptoms. Disease-related data will be collected from patients' files and from additional physical examinations and laboratory tests.The two interventions will be comparable in terms of format (small group work), duration (six sessions) and approach (interactive learning; supporting the participants' active roles). The group treated as usual will be informed about their screening results and about the importance of treating depression. They will be provided with brief re-education on diabetes and written self-help instructions to cope with mood difficulties.Primary outcomes will be depressive symptoms. Secondary outcomes will be glycaemic control, diabetes-related distress, self-management of diabetes and health-related quality of life. Tertiary outcomes will be biochemical markers reflecting common pathophysiological processes of insulin resistance, inflammation and oxidative damage that are assumed to be intertwined in both diabetes and depression. The mixed-effect linear model will be used to compare the outcome variables.Power analysis has indicated that the two intervention groups and the control group should comprise 59 patients to enable detection of clinically meaningful differences in depressive symptoms with a power of 80% and alpha = 0.05. Outcomes will be analysed on an intention-to-treat basis.Trial RegistrationISRCTN: ISRCTN05673017

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Depression and Diabetes

Cited by 1,217 publications

References 47 publications

Keys to Successful Diabetes Self-management for Uninsured Patients: Social Support, Observational Learning, and Turning Points: A Safety Net Providers' Strategic Alliance Study

Keys to Successful Diabetes Self-management for Uninsured Patients: Social Support, Observational Learning, and Turning Points: A Safety Net Providers' Strategic Alliance Study

Depression, obesity, and smoking were independently associated with inadequate glycemic control in patients with type 1 diabetes

Does treatment of subsyndromal depression improve depression and diabetes related outcomes: protocol for a randomised controlled comparison of psycho-education, physical exercise and treatment as usual

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