Counseling patients with depression and type 2 diabetes may improve treatment outcomes

Addressing symptoms of depression may be one of the most important aspects of treating a person with type 2 diabetes, according to a new investigation from the VA Ann Arbor Health System.

Depression is very common in diabetics. Studies have shown a high prevalence of the mood disorder, particularly in older individuals with the disease. This can impact their metabolic condition, as depressed diabetes patients are less likely to follow prescribed treatment programs.

However, in addition to improving mood, programs designed to treat depression in type 2 diabetes patients may also improve metabolic function, the study, which was published in the journal Medical Care, showed.

For the investigation, researchers divided a group of 291 participants with type 2 diabetes and significant depressive symptoms into two groups. One group received standard care, while the other segment was put through a year-long intervention program, which consisted of 12 weeks of cognitive behavioral therapy and nine months of supplemental phone checkups.

The researchers said that most of the participants entered the study with fairly well-controlled blood sugar, so there was little change in either group's average HbA1c test results. However, those in the intervention group did see an average four-point improvement in systolic blood pressure during the course of the study. No such improvement was seen in the control section.

Additionally, 58 percent of the patients who received counseling had depression symptoms that were in remission by the end of the one-year study, while only 39 percent who did not receive therapy experienced improvements in depressive symptoms.

"Patients with depression and additional chronic medical conditions do better if their depression is addressed first, if it is addressed systematically and if exercise is also encouraged," said Marcia Valenstein, who led the study. "Delivering therapy by telephone makes it feasible to reach large numbers of patients who may not attend traditional in-person appointments."