ADA 2014: Is It Depression or Diabetes Distress?


The Particulars: Researchers have yet to clearly define whether the symptoms of depression observed in patients with diabetes are actually depression or a reaction to living with a stressful, complex disease that is often difficult to manage.

Data Breakdown: A study group from the University of California, San Francisco developed diabetes-specific distress measures that reflected whether patients had been feeling worried about a variety of problems associated with diabetes, including hypoglycemia. Study participants also completed the Patient Health Questionnaire-8 (PHQ-8) to measure depressive symptoms. Those with high levels of distress and depressive symptoms were assigned to one of three interventions meant to reduce diabetes distress rather than manage depression. Distress and depressive symptoms were lower with all three interventions over a 12-month period and maintained throughout the study. Among those who scored higher than 10 on the PHQ-8 at the beginning of the study, 84% reduced their levels to below 10 after receiving the interventions.

Take Home Pearl: Many of the depressive symptoms reported by patients with type 2 diabetes appear to be related to concerns about their diabetes rather than clinical depression. These symptoms appear to be treatable by diabetes care teams without requiring psychologic or psychiatric referrals.

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