P0172 - Some particularities of depression in diabetic patients

Abstract

The presence of diabetes doubles the odds of comorbid depression. In patients with preexisting diabetes, depression is an independent risk factor for coronary disease and appears to accelerate the presentation of coronary heart disease. Concurrent depression is associated with a decrease in metabolic control of diabetes mellitus, poor adherence to medication and diet regimens, a reduction in quality of life and an increase in health care expenditures.

Objective:

To diagnose and treat the depression illness in diabetic patients.

Methods:

A sample of 30 diabetic patients (15 women, 15 men), mean age 59,6 years was assessed for depression - ICD 10 criteria. HAM-D (Hamilton for depression scale), CGI-S (Clinical global impression –severity) and CGI-I (Clinical global impression –improvement) were performed at baseline, 7, 14, 21, 28 and 42 days. Patients received antidepressive medication: tianeptine 37,5 mg/day or venlafaxine 75-150 mg/day.

Results:

Mean score HAM D at baseline was 21.4. The reassessment after 7, 14, 21, 28 and 42 days revealed significant decrease of depressive symptomathology after 4 weeks of medication (HAM D was 15.4). After 42 days the mean score HAM-D was 9,5. CGI-S at baseline was 4.5 and on 42 day 1.8. Mean blood glucose was evaluated from 215,5 mg/dl at inclusion and 142,3mg/dl on day 42.

Conclusions:

1) Successful treatment of depression is associated with improvements in glycemic control. 2) Improvements in mood increase the functioning and quality of life. 3) Further studies are important to demonstrate the role of maintenance antidepressant treatment for the prevention of recurrence.