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Glycemic control not improved by depression treatment
April 27, 2007
www.reutershealth.com
By Will Boggs, MD
NEW YORK (Reuters Health) - Improvements in depressive symptoms are not associated with improvements in glycemic control in diabetic patients, according to a report in the current issue of Psychosomatic Medicine.
"While clinical depression should be treated in all patients, treating depressed mood (non-clinical depression) in patients with type 2 diabetes as a strategy to improve glycemic control is not effective," Dr. Richard S. Surwit from Duke University Medical Center, Durham, North Carolina told Reuters Health.
Dr. Surwit and associates investigated whether changes in affective symptoms after cognitive behavior therapy would differentially affect glycemic control in 28 patients with type 1 diabetes and 62 with type 2 diabetes. Twenty-one type 1 diabetes patients and 44 type 2 patients completed the 12-month follow-up period.
Overall, changes in depression symptoms, as measured by Beck Depression Index (BDI), did not affect HbA1c level or fasting blood glucose concentration, the authors report.
Similarly, although post-treatment Hamilton Depression Scale values improved for all patients, these improvements were not matched by improvements in HbA1c or fasting blood glucose.
Even among the subgroup of 17 patients with clinical depression, the researchers note, there was no evidence of an improvement in HbA1c level as depression improved.
"The working hypothesis of the present study was that improving depression through cognitive behavior therapy would differentially impact patients with type 1 and type 2 diabetes," Dr. Surwit said. "Therefore, the finding that significantly improving BDI with cognitive behavior therapy failed to impact HbA1C in either type 1 or type 2 patients was somewhat of a surprise."
"We are currently investigating the relationship between depression and the onset of diabetes in a large longitudinal sample of Viet Nam veterans," Dr. Surwit added. His team is also "studying the effects of hostility, a personality construct with some overlap with depression, on glycemic control in various non-diabetic populations."
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