Posts Tagged ‘depression’

Lifestyle change leads to improvement in Diabetes, Depression

When the status quo in one’s state of health is unacceptable, change is a welcome thing.  Identifying and making change happen can experienced as problematic.  Physical movement of any type is some form of physical change, if only in ending in a different state than when/where one started. Lifestyle change can be a tall order for most of us, however one may confidently begin with baby steps that cannot be denied, such as going for a walk, or making a conscious choice of whatever type.

Here is a study abstract that associates lifestyle change with improved outcomes for those with diabetes and depression diagnoses. Click on the URL below to gain access to the full text of this report.

Intensive Lifestyle Changes Lead to Lasting Improvement in T2DM
Reduction in incidence of mild or greater depression symptoms; improved physical function
MONDAY, June 2, 2014 (HealthDay News) — For obese/overweight adults with type 2 diabetes, an intensive lifestyle intervention (ILI) is associated with a reduced risk of incident depression and with better physical function, according to a study published in the June issue of Diabetes Care.

Thomas A. Wadden, Ph.D., from the University of Pennsylvania in Philadelphia, and colleagues compared the effects of an ILI with a diabetes support and education (DSE) control intervention on long-term changes in depression symptoms, antidepressant medication use, and health-related quality of life. Participants included 5,145 overweight/obese individuals with type 2 diabetes who were followed for a median of 9.6 years. They administered the Beck Depression Inventory (BDI) at baseline, annually at years one to four, and at year eight.

The researchers found that, compared with DSE, ILI correlated with a significant reduction in the incidence of mild or greater depression symptoms (BDI scores ≥10; hazard ratio, 0.85; P= 0.0145). Both groups experienced a worsening of Medical Outcome Study Short Form 36 (SF-36) physical component summary scores over time, but throughout the first eight years the ILI participants reported better physical function than DSE participants (all P values < 0.01). No significant between-group differences were seen in the proportion of participants who used antidepressant medications or in SF-36 mental component summary scores.

“These findings should be considered when evaluating the potential benefits of ILIs,” the authors write.

Several authors disclosed financial ties to the pharmaceutical and weight loss industries.

Diabetes and Depression Combination Raises Heart Attack Risk

This article presents evidence that links a measure of experienced state of  well-being generated in the mid-brain (depression) with a metabolic condition (diabetes) and the risk of myocardial infarction (heart attack.  All three systems are fed by the vagus (ninth cranial) nerve and can be regulated by mindfulness practices.

It was downloaded from open source:


Diabetes and Depression Combo Hikes MI Risk

Published: Sep 26, 2013 | Updated: Sep 27, 2013

By Todd Neale, Senior Staff Writer, MedPage Today
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner

BARCELONA — Individuals who have both diabetes and depression have an increased likelihood of having a myocardial infarction (MI), a large Swedish study affirmed.

The odds of having an MI compared with individuals without either condition were greatest among those ages 45 to 64, with the strongest association seen in women (OR 7.1, 95% CI 6.1-8.2), according to Karin Rådholm, of Linköping University in Sweden.

The corresponding odds ratio for men in that age group was 2.8 (95% CI 2.5-3.2), Rådholm reported at the European Association for the Study of Diabetes meeting here.

The chances of having an MI were also elevated — but to a lesser extent — in men and women who had either diabetes or depression, but not both.

Previous studies have shown an association between diabetes and depression, and a study published last year showed that treating both conditions simultaneously in the primary care setting was associated with improved glycemic control. Patients with both conditions have been shown to have an increased cardiovascular risk.

Rådholm and colleagues explored the link between diabetes, depression, and MI using data on 3,738,524 individuals ages 45 to 84 from Swedish national registries of prescription drug use, hospitalizations, and deaths. The analysis excluded those who had had an MI before the beginning of the study period.

Prescriptions for medications for diabetes and depression were used as surrogates for the conditions themselves.

The researchers divided the patients into four groups, which could be shuffled each of the 3 years of the study, based on drug use:

  • Neither type of medication
  • Anti-diabetics only
  • Antidepressants only
  • Both types of drugs

During the 3-year follow-up, 1.2% of the participants had a first MI. Of those, 37% were fatal.

In the older half of the cohort (ages 65 to 84), all three of the drug groups carried an increased likelihood of having an MI, with odds ratios ranging from just over 1.0 to about 3.0 compared with non-users. The greatest odds were observed in those taking both types of medication and in women versus men.

The findings were similar in the younger half of the cohort (ages 45 to 64), with odds ratios ranging from just over 1.0 to about 7.0. The results were not changed by adjustment for the use of anti-hypertensives.

The findings were not surprising, according to Ewan Pearson, PhD, MBBChir, of the University of Dundee in Scotland. “It’s a very nice, large study that establishes the fact that people with diabetes and people with depression have higher rates of cardiovascular events,” said Pearson, who co-chaired the session at which Rådholm presented the results.

What is noteworthy is the large sample size used in the analysis, he said.

“A study of 3.7 million is incredible,” he said. “It just shows the utility of these massive population resources that Sweden has access to.”

Rådholm acknowledged that the study was limited by the lack of information on the indications for use of antidepressants, noting, for example, that tricyclics can be used for neuralgias and other conditions. The analysis also lacked information on important confounders, such as smoking, lipid levels, and lifestyle.

Rådholm did not report any conflicts of interest.