Local study to examine the diabetes and depression link
In 2007, the Centers for Disease Control and Prevention (CDC) conducted a study to determine the county-by-county picture of diabetes in the United States. According to their findings, 81 percent of the counties that makeup the Appalachian region, which include Pennsylvania and West Virginia, had high rates of obesity and Type 2 diabetes.
While many people know the majority of complications that are associated with Type 2 diabetes, such as heart and blood vessel disease; nerve, kidney, foot and eye damage; and hearing impairment, there is still a lesser known side effect that is currently being studied at the West Virginia University School of Medicine Department of Exercise Physiology.
Program ACTIVE, created by the department, is currently looking for people to volunteer to be a part of a study that is exploring the connection between diabetes and depression.
According to Dr. Guy Hornsby, the WVU principal investigator of Program ACTIVE, many diabetics in the local region are also affected by depression.
“We have a much higher incidence of Type 2 diabetes. One in four with Type 2 diabetes are depressed,” he said. “We know there is a higher incidence of diabetes and depression in the Appalachian region.”
Currently, people know that diabetes and depression can go hand in hand. However, just like the chicken and egg philosophy, people are unsure as to which comes first; diabetes or depression.
“It is not an easy answer. We know Type 2 diabetes is a genetic disorder. For most people they will come down with Type 2 diabetes and as they are managing their disease and they will suffer from depression,” explained Hornsby. “They are saying that probably depression has some genetic links to it as well. We know that depression runs in families and more than likely there are specific genes that will cause Type 2 diabetes and will cause depression.”
Another possible cause for the depression and diabetes link is the toll that having a chronic disease, such as diabetes, can take on a person. However, working with a professional to handle the depression can help in the individual’s overall health.
“Just the day to day management and everybody looking at them that they have diabetes and they have to watch what they have to eat. That is a tremendous burden that they have to be in control of their disease. I worked as a diabetes educator for 25 years. Diabetes can be managed. It does take a lot of work,” said Hornsby. “Physiologists are very good at helping to shape their behavior, helping people accept things they cannot change. I don’t believe that diabetes is a disease that has to suffer from depression and it can be helped.”
Depression can cause numerous problems for anybody, but with diabetes there are additional concerns when it comes to properly managing the disease.
“In Type 2 diabetes, if not treated, it (depression) makes the diabetes a lot worse than it should be,” said Hornsby. “When a person becomes depressed, many of the lifestyle managements of the disease, such as watching the diet and getting in enough physical activity, sometimes those things are ignored because they don’t have enough energy to do what they need to do to manage their disease. The blood glucose gets worse. We know that because the A1C level, which is the time-average over three months the measure of what their blood glucose is, begins to rise in depression, and it is a lot higher than those who are not depressed.”
One of the goals of Program ACTIVE is to help diabetics with their complications from diabetes while also teaching them how to manage their depression.
“In Program ACTIVE we are trying several proven strategies with helping people with depression. Those (strategies) are talk therapy and we are trying physical activity,” said Hornsby. “We feel that physical activity, which is part of the management of diabetes, will help their depression. We are looking at the combination of having them (the study volunteers) in physical activity programs and physiological counseling at the same time. That combination therapy at a pilot program at Ohio University was able to reduce depression by 77 percent.”
While Program ACTIVE is working to help individuals who are dealing with both diabetes and depression, Hornsby also hopes this program can serve as a model for communities across the country.
“The links between depression and poor control of diabetes and depression and fatal heart disease they are so strong it is such an overwhelming problem that we have to do something,” he said. “We are trying to do this in local communities and set-up a model where local communities can see they can help people with Type 2 diabetes who are depressed.”
Those wishing to participate in Program ACTIVE must have been diagnosed with Type 2 diabetes at least a year ago and have experienced symptoms of major depression for at least two weeks. These symptoms include: anxiety or feelings of emptiness; persistent sadness; loss of interest in formerly pleasurable activities; having a hard time concentrating or making decisions; and feeling fatigued or a decrease in energy.
Participants must also be at least 18 years of age and will be screened for eligibility over the phone. Once approved for the study, they will have to go to a community-based site for a baseline assessment that will include bloodwork, a psychological questionnaire about depression and a six-minute walk test. All treatment and assessment for the study will take place in the participant’s home communities.
This study is a collaboration of WVU, Ohio University and Indiana University.
Anyone interested in participating in the study should call 855-DMACTIV or call Project Coordinator Susan Eason directly at 304-293-7322. The deadline for participation is March 1, 2015.