Psychosocial management may help reduce depression, eating disorders associated with diabetes
Behavioural and emotional management can help reduce depression and disordered eating in patients with diabetes, according to two studies presented at the ADA 2017 in San Diego, California, US.
One of the studies, Program ACTIVE* II, evaluated the effectiveness of cognitive behavioural therapy (CBT) and physical exercise in 140 adults with major depressive disorder and type 2 diabetes (T2D). Participants were randomized to individual talk therapy/CBT sessions, personal trainer-guided exercise, CBT plus exercise, or usual care over 12 weeks. [ADA 2017, abstract 376-OR]
Compared with usual care, CBT, exercise, and CBT+exercise resulted in fewer depressive symptoms (all p<0.05), reduced negative automatic thoughts (all p<0.03), improved physical quality of life (QoL, exercise and CBT+exercise, p<0.01; CBT, p<0.03), and a lower diabetes distress (p<0.01).
“Depression occurs at higher rates in people with diabetes … and has significant implications for physical and mental health,” said lead author Dr Mary de Groot from the Diabetes Translational Research Center at Indiana University, Bloomington, Indiana, US. Program ACTIVE II demonstrated how talk therapy and guided exercise can effectively manage both depression and diabetes, she added.
In the SEARCH for Diabetes in Youth study which evaluated young individuals with type 1 diabetes and T2D, researchers observed disordered eating behaviours in 21.2 and 52.2 percent of participants, respectively. [ADA 2017, abstract 802-P]
The risk for developing disordered eating behaviours comes with the intense focus on weight and diet in diabetes management. However, as these conditions are mostly under-recognized, diabetes management and overall general health might be compromised, said lead author Dr Angel Siu Ying Nip from the University of Washington, Seattle, Washington, US.
“[Therefore], it is paramount to raise awareness among health providers, … families, and patients to identify at-risk patients early, and to offer appropriate counselling and treatment if necessary. Providers should educate patients and families to make sustainable healthful lifestyle choices rather than focus on a specific weight-loss goal,” said Nip.
In light of these findings, the Mental Health Provider Diabetes Education Program was jointly initiated by the ADA and the American Psychological Association to help support licensed caregivers for diabetic patients with mental health issues by providing educational courses about psychosocial care for these patients.
“This initiative will have a positive impact on care and lead to optimal health outcomes for [diabetics], and … offer practical solutions to providing psychosocially-minded diabetes care, screening for psychosocial needs, and making referrals or treating those needs,” said programme team member Dr Korey Hood from Stanford University, Stanford, California, US.
“As more collaborative efforts like these take place, the psychosocial side of diabetes can be more adequately and appropriately addressed,” added Hood, who noted that further research is warranted regarding the programme’s implementation in both primary and specialty care settings.