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Can Lifestyle Interventions Do More Than Reduce Diabetes Risk? Treating Depression in Adults With Type 2 Diabetes With Exercise and Cognitive Behavioral Therapy

  • Translational Strategies for Diabetes Prevention (D Marrero, Section Editor)
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Abstract

The epidemic of metabolic syndrome, prediabetes, and type 2 diabetes is global in scope and comprehensive in its impact on individuals, health care systems, and societies. One in four patients with diabetes will experience depression in their lifetime. Comorbid depression is associated with poorer outcomes, greater functional disability, and early mortality. Prior studies have demonstrated beneficial effects of exercise as an efficacious form of treatment for depression in the general population. Few studies have evaluated this strategy in patients with prediabetes or type 2 diabetes. Program ACTIVE (Appalachians Coming Together to Increase Vital Exercise) was designed to treat depression among adults with type 2 diabetes by pairing aerobic activity with individual cognitive behavioral therapy. This combination treatment approach has been shown to be feasible to implement in a rural environment and promising in terms of depression, diabetes, and cardiovascular outcomes. Data from this study suggest that exercise can be used to achieve multiple benefits for adults with type 2 diabetes. Future work to compare this approach to singular treatment strategies for adults at risk for type 2 diabetes is needed.

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Acknowledgments

Funding for this study was provided by the National Institutes of Health R34DK71545, Ohio Department of Health, Office of Healthy Ohio, Bureau of Health Promotion and Risk Reduction, Diabetes Prevention and Control Program, and the Ohio University Diabetes Research Initiative.

We wish to thank the following individuals and organizations for their contribution to Program ACTIVE: The Athens Community Center; Al Miller, Debbie Piatt and Christine Roush at the Marietta Family YMCA; Joe Leaman at HealthSouth Sports Medicine and Outpatient Rehabilitation, Inc.; Jean Andrews, M.S., Mark McGlynn, B.S., Mike Knutson, B.S., Dustin Hammers, Ph.D., Zina Trost, Ph.D., Candace Patterson, Ph.D., Jessica Turchik, M.S., Diane Turcotte, M.S.., Andrea Waltje, M.S., Travis Lovejoy, Ph.D., Petya Demireva, M.S., Troy Robison, M.S., Jamie Huckins, M.S., Claire Russell, B.S., and Madeline Vardell. We also wish to thank Judith Wylie-Rossett, Ph.D., Patrick J. Lustman, Ph.D., James Blumenthal, Ph.D., Ann Rathbun, Ph.D. and Sharon Denham, Ph.D. for their expert consultation in the development of study materials.

Disclosure

Conflicts of interest: M. de Groot: has received grant support from the NIDDK; has been a consultant for Johnson & Johnson Diabetes Institute; and has received payment for lectures including service on speakers bureaus from Lilly Foundation; T. Doyle: none; M. Kushnick: has received grant support from NIH (R34DK71545) and the Ohio Department of Health; J. Shubrook: none; J. Merrill: none; E. Rabideau: received grant support from the Diabetes Research Initiative (DRI) at Ohio University; F. Schwartz: has received grant support from the NIDDK and NIH.

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de Groot, M., Doyle, T., Kushnick, M. et al. Can Lifestyle Interventions Do More Than Reduce Diabetes Risk? Treating Depression in Adults With Type 2 Diabetes With Exercise and Cognitive Behavioral Therapy. Curr Diab Rep 12, 157–166 (2012). https://doi.org/10.1007/s11892-012-0261-z

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