Tailored cognitive behavioural therapy (CBT) and lifestyle counselling could significantly improve the mental health of people with type 2 diabetes and depression, researchers suggest.
Compared with standard care, the intervention was also associated with improved HbA1c levels and improved self-care behaviours.
A US team from East Carolina University developed the approach which involved 16 sessions of behavioural treatment that had been specifically tailored for each individual with type 2 diabetes.
The sessions were tailored based on their level of depression and/or distress relating to their type 2 diabetes.
Those with lower levels of depression were given lifestyle coaching which encouraged small changes, while those with higher distress and depression levels received CBT plus lifestyle coaching.
The work was carried out at a rural primary care practice in the south eastern part of America. Each session lasted between 30-60 minutes.
The participants were then re-evaluated at the six-month mark, and their therapy levels were adjusted if needed. After 12 months the research team said those who received the CBT had improvements in their HbA1c levels, depressive symptoms and had improved their self-care behaviours. However, the differences between the groups did not classify as being statistically significant.

Lead author Dr Doyle Cummings said: “Taken together, the current study is among one of the only randomized trials demonstrating that a tailored, integrated care model can result in improvements in both behavioural and glycaemic outcomes in a rural primary care setting.”
Cummings and colleagues added: “Despite the improvement in HbA1c, mean values remained substantially above target at 12 months follow-up, and more aggressive pharmacologic treatment may be needed as psychological symptoms are reduced.
“Therefore, continuing to develop treatment models that integrate both medical and behavioural care in order to maximize treatment outcomes is critical.”
The findings have been published in the journal Diabetes Care.

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