CBT Improves Blood Sugar Levels in Depressed Patients

Rebecca Lewis February 26, 2014

Not only does cognitive therapy help depressed individuals deal with their condition, it may also help them control their blood sugar levels, a new study found.

Researchers from Massachusetts General Hospital (MGH) report that a programme of cognitive behavioural therapy (CBT) that addressed both mood and diabetes self-care led to improved blood sugar control and produced faster relief of depression in patients with poorly-controlled type II diabetes.

The study involved 87 adults whose type II diabetes was poorly controlled despite treatment with oral medications and who also met criteria for a diagnosis of depression.

At the start of the trial, all participants received an enhanced version of usual diabetes self-care counselling, which included meetings with a nurse educator to set goals for blood sugar monitoring, with a dietician to set dietary and exercise goals, and with a counsellor to set strategies for meeting those goals and other medical recommendations. A subgroup of 45 randomly selected participants took part in 9 to 12 additional weekly cognitive behavioural therapy (CBT) sessions where they worked on problem-solving strategies, reviewed how well they met goals in the previous week, and tracked their moods.

While the sessions included typical aspects of CBT for depression, such as training in adaptive thinking, relaxation and activity scheduling, they also focused on specific elements of diabetes self-care.

“The association between depression and type II diabetes is well documented, but clinical trials of either medication or psychological treatment for depression have had mixed or negative effects on adherence to treatment programs,” said Steven Safren, Ph.D., one of the researchers.

“In this study we adapted our approach that has improved treatment adherence among HIV/AIDS patients by addressing both depression and treatment self-management skills.”

Throughout the year-long study period, participants in both groups continued any previously prescribed depression treatment; but if symptoms were found to have worsened at assessment visits, they were referred for additional therapy or adjustments to antidepressant medication. At the end of the first four months, participants receiving the integrated CBT treatment were significantly more successful than the usual-treatment group in adhering to their prescribed medications and their glucose monitoring schedule.

“It is possible,” Safren notes, “that participants in the usual-treatment group were more likely to be referred for additional depression treatment after the four-month assessment, since they were less likely to show improvement at that visit.”

“We are hopeful that this approach can be helpful in treating any medical illness in which patients also have depression,” Safren said.

Their work was published in the journal Diabetes Care.

Source of this article:

Cognitive Therapy Helps Depressed Diabetics Control Blood Sugar