Biobehavioral Bases & Management of Type 2 Diabetes and Depression

University Of Miami Coral Gables, Coral Gables FL

Investigators

Linked publications & trials

Abstract

Type 2 diabetes is a major risk factor for coronary heart disease (CHD). Obesity, poor glycemic control,[unreadable] depression, low socioeconomic status (SES) and being a member of a racial/ethnic minority group all[unreadable] increase this risk. The major objective of this project is to determine if compared to Standard Care (SC), a[unreadable] Community Approach to Lifestyle Modification for Diabetes (CALM-D) program including diet, exercise and[unreadable] coping skills training, can decrease depression, weight and HbA1c and improve medication adherence in low[unreadable] income, primarily Black and Latino/Hispanic, depressed, overweight, Type 2 diabetic patients seen in a[unreadable] large, comprehensive, community health center. Both CALM-D and SC will be prescribed a selective[unreadable] serotonin reuptake inhibitor (SSRI) by their primary physician for treatment of major depression. The project[unreadable] will compare 100 CALM-D (75 expected completers) and 100 SC (75 expected completers) participants.[unreadable] Following 3 run-in sessions given to both SC and CALM-D participants, SC patients will be treated in[unreadable] accordance with ADA Clinical Practice Guidelines (2005) and also assessed by project staff at baseline, 6[unreadable] months and 1 year. All biomedical data collected will be summarized and forwarded to each patient's[unreadable] physician. The CALM-D participants will receive 2 individual stress management and lifestyle sessions[unreadable] followed by 2 weekly group sessions. Then 4 bi-weekly sessions will be followed by 9 monthly sessions for a[unreadable] total of 17 sessions. CALM-D participants will be encouraged to bring a spouse or someone living in the[unreadable] house to treatment sessions. This is intended to provide both emotional and tangible support for[unreadable] participants. Secondary objectives of the project are to determine if compared to SC, CALM-D can improve[unreadable] glucose tolerance to challenge, insulin resistance, oxidative stress, inflammation, procoagulation, lipid profile,[unreadable] endothelial function resting blood pressure, cardiac and vascular function, cardiac morphology, psychosocial[unreadable] functioning and health quality of life. As many of the participants will already have been prescribed aspirin,[unreadable] statins, oral hypoglycemics and other medications, an important objective of the project will be to assess the[unreadable] extent to which improved adherence to medications - a goal of the CALM-D program - can account for[unreadable] improved intervention effects.