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Depression in diabetic patients: the relationship between mood and glycemic control.

Abstract

PROBLEM

Evidence from prospective and cross-sectional studies demonstrates that the presence of diabetes doubles the risk of comorbid depression. This commonly overlooked comorbidity affects more than one quarter of the diabetic population, making its recognition and treatment in diabetic patients clinically relevant.

METHODS

PubMed, PsycINFO, and MEDLINE databases were searched (search words: diabetes, depression, metabolic control, hyperglycemia, hypoglycemia) for articles that evaluated outcomes, relationships, and/or management of comorbid depression and diabetes published between 1980 and 2002. This review represents a synthesis of the findings including treatment recommendations.

RESULTS

Concurrent depression is associated with a decrease in metabolic control, poor adherence to medication and diet regimens, a reduction in quality of life, and an increase in health care expenditures. In turn, poor metabolic control may exacerbate depression and diminish response to antidepressant regimens. Psychotherapy and pharmacotherapy are effective in the presence of diabetes; both cognitive behavior therapy and selective serotonin reuptake inhibitors are weight neutral and have been associated with glycemic improvement in some studies.

CONCLUSION

Depression is common in both type 1 and type 2 diabetes and has significant effects on the course and outcome of this medical illness. Conventional antidepressant management strategies are effective and the regimen should be tailored to the individual patient. Enhanced efforts toward good glycemic control may also contribute to improvements in mood and perceptions of well-being.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA. lustmanp@msnotes.wustl.edu

    Source

    MeSH

    Adult
    Blood Glucose
    Depression
    Depressive Disorder
    Diabetes Mellitus
    Diabetes Mellitus, Type 2
    Humans
    Risk Factors

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural
    Research Support, U.S. Gov't, P.H.S.
    Review

    Language

    eng

    PubMed ID

    15745842

    Citation

    Lustman, Patrick J., and Ray E. Clouse. "Depression in Diabetic Patients: the Relationship Between Mood and Glycemic Control." Journal of Diabetes and Its Complications, vol. 19, no. 2, 2005, pp. 113-22.
    Lustman PJ, Clouse RE. Depression in diabetic patients: the relationship between mood and glycemic control. J Diabetes Complicat. 2005;19(2):113-22.
    Lustman, P. J., & Clouse, R. E. (2005). Depression in diabetic patients: the relationship between mood and glycemic control. Journal of Diabetes and Its Complications, 19(2), pp. 113-22.
    Lustman PJ, Clouse RE. Depression in Diabetic Patients: the Relationship Between Mood and Glycemic Control. J Diabetes Complicat. 2005;19(2):113-22. PubMed PMID: 15745842.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Depression in diabetic patients: the relationship between mood and glycemic control. AU - Lustman,Patrick J, AU - Clouse,Ray E, PY - 2003/10/24/received PY - 2004/01/20/revised PY - 2004/01/21/accepted PY - 2005/3/5/pubmed PY - 2005/7/1/medline PY - 2005/3/5/entrez SP - 113 EP - 22 JF - Journal of diabetes and its complications JO - J. Diabetes Complicat. VL - 19 IS - 2 N2 - PROBLEM: Evidence from prospective and cross-sectional studies demonstrates that the presence of diabetes doubles the risk of comorbid depression. This commonly overlooked comorbidity affects more than one quarter of the diabetic population, making its recognition and treatment in diabetic patients clinically relevant. METHODS: PubMed, PsycINFO, and MEDLINE databases were searched (search words: diabetes, depression, metabolic control, hyperglycemia, hypoglycemia) for articles that evaluated outcomes, relationships, and/or management of comorbid depression and diabetes published between 1980 and 2002. This review represents a synthesis of the findings including treatment recommendations. RESULTS: Concurrent depression is associated with a decrease in metabolic control, poor adherence to medication and diet regimens, a reduction in quality of life, and an increase in health care expenditures. In turn, poor metabolic control may exacerbate depression and diminish response to antidepressant regimens. Psychotherapy and pharmacotherapy are effective in the presence of diabetes; both cognitive behavior therapy and selective serotonin reuptake inhibitors are weight neutral and have been associated with glycemic improvement in some studies. CONCLUSION: Depression is common in both type 1 and type 2 diabetes and has significant effects on the course and outcome of this medical illness. Conventional antidepressant management strategies are effective and the regimen should be tailored to the individual patient. Enhanced efforts toward good glycemic control may also contribute to improvements in mood and perceptions of well-being. SN - 1056-8727 UR - https://www.unboundmedicine.com/medline/citation/15745842/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S1056872704000042 DB - PRIME DP - Unbound Medicine ER -