Study urges effective treatment of depression in people with diabetes

Effectively treating depression lowered risk of death among older people with diabetes in a new study.
The study, which compared standard diabetes care with diabetes care plus structured depression care management, emphasises the importance of proper mental health treatment in people with diabetes.
The researchers used data from 1,226 people, all of whom were over the age of 60. Each participant was asked to fill out a questionnaire about their health, including information about chronic diseases such as heart disease and diabetes.
Each participant was then given either standard care or standard care plus structured treatment for depression. Diabetes patients given structured depression treatment were 53 per cent less likely to die over the course of the study, an improvement the researchers ascribed to the structured depression treatment. These improvements applied to all participants with chronic disease, but the most significant was, by far, seen in people with diabetes.
In fact, after four months of structure depression treatment, 40 per cent of participants were completely relieved of depressive symptoms. In people receiving standard depression treatment, this figure was 22.5 per cent. This suggests that structured depression treatment is more effective in older people than standard care.
“Older adults with depression and medical comorbidity pose a significant clinical and public health challenge,” the researchers wrote. “Evidence was found of a statistically significant intervention effect on mortality for diabetes mellitus in persons with major depression.”
Why would treating depression lower the risk of death in people with diabetes?
Diabetes is a chronic disease that requires daily management. Because depression can have such a severely detrimental effect on motivation, many people with diabetes who also have depression neglect their management of blood glucose levels. Poorly controlled blood glucose levels increase the risk of a range of complications, including heart disease, which is the most common cause of death in people with diabetes.
Diabetes and mental health
This study highlights the profound need for greater mental health care for people with diabetes, who are, according to several studies, between two and three times more likely to have depression than people without diabetes.
Mental health was addressed at length by the American Diabetes Association (ADA), in its Standards of Medical Care in Diabetes 2016 revisions. The ADA urges clinicians to incorporate psychological assessment into standard diabetes care, rather than waiting for symptoms of mental health problems. The document states:
“It is preferable to incorporate psychological assessment and treatment into routine care rather than waiting for a specific problem or deterioration in metabolic or psychological status.”
The guidelines, along with these new findings, indicate that the issue of mental health is being given more serious consideration than ever before.
The findings are published in the Journal of the American Geriatrics Society.