Washington: Antidepressant medication may reduce the risk of recurrent depression and increase the length of time between depressive episodes in patients with diabetes, according to a team of researchers at Washington University School of Medicine in St. Louis.
"That's important not only because people with diabetes will feel better if we can control their depression,” says Patrick J. Lustman, Ph D, principal investigator and professor of psychiatry.
“It's also key to helping manage blood sugar, as depression improves, glucose levels also tend to improve,” he adds.
Although depression affects about five per cent of the general population, the rate is about 25 per cent for patients with diabetes.
Lustman's team previously demonstrated that treatment with antidepressant drugs and psychotherapy is an effective way to treat depression in patients with diabetes, but often depression would quickly redevelop.
"As we better understand depression, it's clear that for many patients, it is a chronic and recurring disease," Lustman says.
"That appears to be especially true for patients with diabetes compared to those otherwise free of medical illness,” he adds.
Although they knew that short-term treatment with antidepressants was helpful with mood and with control of blood glucose, Lustman's team didn't know whether the drug could prevent the recurrence of depression in patients with diabetes.
They also didn't know, what would happen to glucose levels in the months following successful depression therapy.
So Lustman teamed up with investigators at the University of Arizona, Tucson, and at the University of Washington, Seattle.
They studied a total of 152 patients with diabetes at the three sites. The sample included patients with Type 2 diabetes and patients with juvenile or Type 1 diabetes.
After their depression was under control, half of the study patients continued to take sertraline while the other half took an inactive placebo. Patients were followed for up to a year or until their depression recurred.
During that time, investigators regularly measured blood glucose levels by keeping track of hemoglobin A1C, which reflects an individual's control of blood glucose over two to three months.
At one year, more than 65 per cent of those still taking sertraline remained in remission from their depression. Only about 48 per cent of those taking placebo were still in remission.
"That's very important. We now know that controlling depression, by whatever method--whether with exercise, activity, cognitive therapy or medication--improves the likelihood that blood glucose will be better controlled,” Lustman says.
That's the key to preventing the complications of diabetes, such as eye disease, neuropathy and kidney disease," he adds.
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