Not just the body: dealing with stress and depression in diabetes

This study measured the effectiveness of a new therapy program at reducing diabetes-related stress and depression.

Depression is a common problem in patients with diabetes. Roughly 10% of all diabetic patients have major depression, while another 20% display depressive symptoms. Both major and less severe forms of depression have been associated with worse outcomes in diabetes, including reduced quality of life and less satisfaction with diabetes treatments. They also increase the risk of complications, such as blood vessel damage and early death.

Treatment for major or severe depression includes medications (anti-depressants such as Zoloft, Celexa and Prozac) and therapy. The treatment for less severe depression is not as well-defined. Because less severe depression also leads to worse outcomes in diabetics, it is important to understand what treatments are helpful. A new therapy program, Diabetes Motivation Strengthening (DIAMOS), could be helpful for patients with depressive symptoms. This program assists patients in dealing with the stress that comes with diabetes treatments.

The current study measured the effectiveness of DIAMOS in diabetic patients with depressive symptoms. 214 patients were randomly assigned to undergo DIAMOS therapy or the standard education program for diabetic patients. Patients in the DIAMOS group took part in 5 group-based sessions with psychologists. The sessions focused on dealing with the stress of diabetes and the treatment and lifestyle changes involved. Patients in the standard treatment group took part in 5 group-based lessons on topics such as diet and exercise. The level of depressive symptoms, diabetes-related distress, and quality of life were measured at the start of the study and 12 months later. Blood glucose [sugar] levels were also measured.

After 12 months the DIAMOS group were 3.9 times more likely to have a reduction in depressive symptoms compared to the standard treatment group. The occurrence of major depression after 12 months was 37% lower in the DIAMOS group compared to the standard group. Diabetes-related distress was also significantly lower in the DIAMOS group.

Both groups saw an improvement in blood glucose control. There were no significant differences in health-related quality of life following either treatment.

This study concluded that a therapy program focused on controlling diabetes-related stress led to a significant reduction in depressive symptoms.