Having the right support makes a big difference
By Natasha Persaud
Taking glucose-lowering medication and antidepressants as directed by a doctor makes it more likely that a person with both diabetes and depression will achieve good glucose control and reduce depression symptoms, suggests a new study in the Annals of Family Medicine.
Many people have both diabetes and depression, which is not surprising considering it’s a two-way street: Depression is a risk factor for type 2 diabetes, and having diabetes increases the risk of later developing depression. It’s a challenge either way. Feelings of depression make it harder for a person with diabetes to take medications regularly, stick to a diabetes diet, exercise and enjoy a good quality of life. The additional medical costs can also increase stress.
This study found that additional support from a health care advocate—who educated patients about depression and type 2 diabetes symptoms and treatments and talked with primary care doctors about individual issues such as side effects and referrals—made a big difference. The study involved 180 patients from three primary care practices in Philadelphia, Pennsylvania, who were randomly assigned to either usual medical care with a primary care doctor or integrated care that included a health care manager.
While the sessions were brief—the total with a patient in-person and by phone amounted to just 2 hours over 3 months—the integrated care manager program proved very effective. Patients who received the intervention were almost twice as likely to achieve Hemoglobin A1C levels of less than 7 percent experience a reduction in depression symptoms after 3 months than people who received standard medical care.
The bottom line: If you have diabetes and depression, seek out additional support and help. Enlist family members and friends to help you assemble a health care team, and talk to your doctor and health insurance company about additional resources. You just may feel better.
Bogner, et al. "Integrated Management of Type 2 Diabetes Mellitus and Depression Treatment to Improve Medication Adherence: A Randomized Controlled Trial." Annals of Family Medicine. 2012 Jan-Feb;10(1):15-22.