These findings are consistent with those observed in urban samples.

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de Groot M, Doyle T, Hockman E, Wheeler C, Pinkerman B, et al. Together, they structure a difficult pair to beat. depression severity was associated with younger age, unemployment and a greater number of prescribed medications. For instance, Meigs County, Ohio, has a poverty rate of 19.8 percent, compared to 10.6 percent for the state of Ohio.

To help patients fight back, a team of Ohio University College of Osteopathic Medicine (OU-COM) and Ohio University researchers have put together a new approach to the double-edged problem.

That rate is similar to the national co-morbidity rate, somewhat surprisingly low considering the relatively high rate of poverty where the patients live. 2007 Jun;30:1602-1604   [Extract]

De Groot and her colleagues inspire doctors to screen their diabetic patients for depression. The aim is to assess improvements made during the program in depression, diabetes and cardiovascular risk factors.
depression Among Type 2 Diabetes Rural Appalachian Clinic Attendees
Diabetes Care.

Program ACTIVE, which is funded by the National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK), combines 12 weeks of exercise with 10 sessions of talk therapy for patients with type 2 diabetes and depression for two weeks or longer. folks with diabetes are twice as likely to have an experience with depression as those without diabetes.

For patients, de Groot said, it is vital to share feelings and mood symptoms with their doctors.

“Diabetes is a difficult disease,” said Mary de Groot, Ph.D., assistant professor of psychology and lead author of a paper produced by the research team. Program ACTIVE (Appalachians Coming Together to

Increase Vital Exercise) is a two-year intervention feasibility study to tryout the effectiveness of a combination of exercise and talk therapy as a treatment for depression in patients with type 2 diabetes.

The researchers point out that previously published studies have shown that depressive symptoms in diabetics are “associated with worsened blood glucose levels, diabetes complications, increased functional disability, worsened adherence to diabetes regimen, higher ambulatory care costs, and increased mortality.”

The study looked at type 2 diabetes patients attending family medicine and endocrinology appointments in rural Appalachian counties of Southeastern Ohio and West Virginia. “Add depression on top of that, and it makes it that much tougher.”

Their paper is published in the June issue of Diabetes Care, the journal of the American Diabetes organization.

“What is compelling is the length of episodes of depression,” said de Groot, the principal investigator. depression does, too. A follow-up study of the patients involved showed that 88 percent of those who had initially identified themselves as suffering from depression plus did so 18 months later. Of those 201 patients, 31 percent reported co-morbid diabetes and depression through completion of the Beck depression stock, a self-report questionnaire assessment.

According to Schwartz, in research conducted by the ARHI Diabetes Center, Appalachia has a diabetes prevalence rate of 11.3 percent - well above the 7.6 percent national rate. It’s vital, too, to know that talk therapy has been shown to be effective in treating depression in type 2 diabetes, she said, and that antidepressant medications have been effective in treating depression in folks with type 1 and type 2 diabetes.

In Appalachia, diabetes hits hard.

Original post by Anxiety Insights

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