Cognitive Behavioral Tx Helpful for Diabetes + Depression
(HealthDay News) — For adults with type 2 diabetes and depression, cognitive behavioral therapy for adherence and depression (CBT-AD) is associated with enduring benefits for diabetes self-management and glycemic control, according to a study published in the March issue of Diabetes Care.
Steven A. Safren, PhD, from Massachusetts General Hospital in Boston, and colleagues examined the impact of CBT-AD using data from 87 adults with unipolar depression and uncontrolled type 2 diabetes. Participants received enhanced treatment as usual (ETAU), including medication adherence, self-monitoring of blood glucose (SMBG), and lifestyle counseling. Participants randomized to the CBT-AD arm also received nine to 11 CBT-AD sessions.
The researchers found that after adjustment for baseline, immediately after acute treatment (four months), there was greater oral medication adherence (20.7%; P=0.000); greater SMBG adherence (30.2%; P=0.000); lower depression scores on the Montgomery-Asberg Depression Rating Scale (6.44 points; P = 0.002); lower Clinical Global Impression (0.74 points; P=0.01); and lower hemoglobin A1c (0.72 units; P=0.001) for CBT-AD versus ETAU. Higher medication adherence (24.3%; P=0.001); greater SMBG adherence (16.9%; P=0.043); and lower hemoglobin A1c (0.63 units; P=0.03) were seen for CBT-AD on analyses of four-, eight-, and 12-month follow-up time points. Some evidence was seen for continued improvement of depression post-treatment, with no between-group differences.
"CBT-AD is an effective intervention for adherence, depression, and glycemic control, with enduring and clinically meaningful benefits for diabetes self-management and glycemic control in adults with type 2 diabetes and depression," the authors write.
Several authors disclosed financial ties to the medical device and pharmaceutical industries; LifeScan donated glucometers and glucose test strips.