Treating the Double Ds is Best

Type 2 diabetes patients with depression may benefit from integrated treatment

(RxWiki News) Living with diabetes can weigh heavily on a person's mental health. In fact, diabetes and depression often go hand in hand. Fortunately, treating both conditions at the same time may lead to better outcomes for patients.

Patients who were treated for both type 2 diabetes and depression at the same time were more likely to continue taking their medications than those who received normal diabetes care.

Patients who received this dual treatment had better blood sugar levels and fewer signs of depression.

"Talk to your doctor about depression if you have diabetes."

According to Hillary Bogner, M.D., M.S.C.E., from the Perelman School of Medicine at the University of Pennsylvania and lead author of this recent study, there are few programs that integrate treatment for these two conditions, even though studies have clearly shown a link between diabetes and depression.

One could say that diabetes and depression feed off of each other. That is, depression may increase your risk of diabetes, and diabetes may increase your risk of depression.

Diabetes patients commonly suffer from depression, which can make them less likely to stay on their medications and lead to worse diabetes management in general.

Dr. Bogner and her colleagues wanted to see if integrated treatment would lead to better outcomes for patients suffering from both conditions. Their integrated care program combined normal primary care with a short program about sticking to drug regimens.

Doctors and patients worked with integrated care managers to identify and deal with the roadblocks that may interfere with a patient's drug regimen.

They found that integrated treatment for diabetes and depression improved patients' adherence to their medications.

"Our results demonstrate that integrated treatment for both conditions, combined with a brief program focused on adherence for primary care patients with Type 2 diabetes and depression, can result in a significant improvement in clinical outcomes," says Dr. Bogner.

"We hope the findings will encourage the adoption of adherence programs aimed at improving outcomes."

Over the course of 12 weeks, the researchers kept track of the time and date that patients took their prescription drugs. They were able to do so through the use of electronic monitors attached to patients' pill bottles.

At the end of the 12-week study period, 60.9 percent of the patients who received integrated treatment had better blood sugar levels, a hallmark of diabetes care. In comparison, improved blood sugar was seen in only 35.7 percent of those who were treated with normal care.

Patients who received integrated treatment also had fewer signs of depression than those treated normally. While 58.7 percent of patients in the integrated care group showed signs of remission of depression, only 30.7 percent of those in the normal care group showed signs of remission.

According to Dr. Bogner, these findings demonstrate that more effort needs to be placed on developing and promoting programs that improve adherence to drug regimens, especially among patients with chronic medical conditions, such as diabetes, and depression.

The full results of the study are published in the Annals of Family Medicine.

This study was supported by a clinical research award from the American Diabetes Association. Dr. Bogner received additional support from a grant from the National Institute of Mental Health.

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Review Date: 
January 23, 2012