by Colin Kenny, GP, Dromore
Depression is more than twice as common in people with diabetes and this is thought to contribute to reduced levels of diabetes control. Investigators in Massachusetts, USA, enrolled 87 adults whose type 2 diabetes was poorly controlled despite treatment with oral medications, and who also met the agreed criteria for the diagnosis of depression. A subgroup of 45 randomly selected participants took part in 9–12 additional weekly cognitive behavioural therapy sessions, where they worked on problem-solving strategies, reviewed how well they met goals of the previous week, and tracked their moods.
The study progressed over 1 year and both groups received appropriate antidepressant medication. At the end of this time participants receiving the CBT treatment were significantly more successful than the usual-treatment group in adhering to their prescribed medications and their glucose-monitoring schedule. They also showed an improvement in blood glucose control similar to what might be seen with the addition of a weak glucose-lowering medication. The researchers had caveats about cost-effectiveness but thought that the CBT intervention could be helpful in treating any medical illness in which patients also have depression.
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