74th Scientific Sessions of the American Diabetes Association (ADA):

Diabetes Distress or Depression in Type 2 Diabetes?

New study research is beginning to have an impact on how clinicians view depression in their patients with Type 2 Diabetes (T2D). The question raised is, are these patients depressed or distressed? Lawrence Fisher, PhD, ABPP, Professor of Family and Community Medicine at the University of California in San Francisco presented his findings during the American Diabetes Association’s 74th Scientific Sessions in June 2014.

Much attention has been given to the prevalence of depression or depressive symptoms in patients with T2D. Many of the symptoms have been associated with poor self-management, improper glycemic control, healthcare costs, and even mortality. Actually, the list is lengthy. Dr. Fisher and his team found that what had previously been considered clinical depression to be largely emotional distress associated with living and managing the challenges and chronicity of diabetes.

Fisher and colleagues questioned if treatments that specifically target diabetes distress also reduced depressive symptoms in adults with T2D. Dr. Fisher said, “If depressive symptoms were reduced by diabetes-specific distress intervention and not a depression intervention, then it would provide further evidence that interventions that focus on distress rather than depression might be a more effective way of addressing the emotional side of diabetes.”

About the Study
The interventional study included 392 distressed patients with T2D, 19 years and older, who were identified from local community patient registries.

  • Patients were randomized into three study arms; each arm used a different strategy or protocol to reduce diabetes distress.
  • Group 1 took part in an online diabetes self-management program.
  • Group 2 participated in the online program and received individual assistance to help resolve diabetes-related problems.
  • Group 3 was provided personalized health risk information and then sent diabetes educational material through the mail.
  • All three groups received personal phone calls during the study.
  • Patients were assessed at baseline, four months, and 12 months  

Results
“We found that all three types of diabetes distress interventions led to significant reductions in diabetes distress at both four and 12 months,” Dr. Fisher related. Furthermore, he stated, “Those patients scoring ≥10 on the Patient Health Questionnaire were no longer within the moderate range of depressive symptoms at four and 12 months. So diabetes distress-targeted interventions also significantly reduced depressive symptoms in these patients.”

Next Summary:
Diabetes Prevention Program Outcomes Study (DPPOS) Highlights
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