Cognitive Therapy May Benefit Depressed Diabetics

By Joan Unger RN, MS, ARNP-C

Researchers found that using a combination of cognitive behavior therapy (CBT) techniques with diabetes education was effective in treating major depression among patients with type 2 diabetes. A bonus was improved glycemic control as well.

Researchers recruited 42 type 2 diabetics suffering major depression for a 10-week study using biweekly diabetes education. Twenty of the subjects also had individual weekly CBT sessions with a psychologist. Researchers used the Beck Depression Inventory to assess depression and glycosylated hemoglobin (HbA1c) to evaluate diabetic control. After 10 weeks, 85% of patients in the CBT group achieved remission of depression, compared with only 27.3% in the control group. At the six-month follow-up, 70% in the CBT group were in remission, compared with 33% of control patients.

The study found no difference in HbA1c levels after 10 weeks, but there was a significant improvement in mean HbA1c levels in the CBT group on six-month follow-up. Researchers noted that improvement in depression may have a positive effect on sleep, dietary practices, physical activity, or physiologic paths involved in glucose regulation. Other experts suggest CBT may help diabetics without depression because it teaches valuable coping skills. It might improve education results for patients feeling overwhelmed by demanding diabetic care, they say.

Source

Lustman P. Cognitive therapy may improve glycemic control in diabetics with depression. Ann Intern Med 1998;129:605-621.