Home > Review Articles > Effect of pharmacological treatment of depression on A1C and quality of life in low-income Hispanics and African Americans with diabetes: a randomized, double-blind, placebo-controlled trial

Effect of pharmacological treatment of depression on A1C and quality of life in low-income Hispanics and African Americans with diabetes: a randomized, double-blind, placebo-controlled trial

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Authors:
Summary:

To determine the value of pharmacological treatment of depression in low-income minorities with diabetes, patients in a Los Angeles County diabetes clinic were screened for depression with Whooley’s two-question tool. A total of 150 subjects answered positively to at least one question on the questionnaire. Eighty-nine depressed subjects with HbA1c levels ≥8.0% were randomly assigned to receive either sertraline or placebo for 6 months. Seventy-eight patients identified as Hispanic, 10 as African American, and one as `Other’. A total of 75 patients completed the study. At 6 months, an intention-to-treat analysis revealed significant differences from baseline for both groups in Hamilton Depression Scale (HAM-D) and pain scores, quality of life, and HbA1c and systolic blood pressure levels; the decreases from baseline in HbA1c and systolic blood pressure levels were significantly greater with sertraline. A significant correlation of 0.45 was observed between the changes in HAM-D scores and HbA1c levels in all subjects (p<10–6).

Comment:
Reading this made me think of my own practice and the fact that I tend to focus on trying to improve glycaemic control through diabetes-specific treatment (i.e. education, self-management, medication) and not consider the risk, let alone management of, depression. I’ll certainly consider it now as a possible factor when HbA1c% remains high
Reference: Diabetes Care 2009;32(12):2156-60.
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

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