Upstate News

June 12, 2006
Doretta Royer 315 464-4833

Depression in elderly diabetics may not hinder control of blood sugar, study finds

SYRACUSE, N.Y. -— While there are reasons why some elderly individuals with diabetes have difficulty controlling their blood sugar levels, depression may not be one of them, according to a recent study led by SUNY Upstate Medical University researchers.

The findings, reported in Diabetes Care, (April 2006), are added proof that depression should not be a reason to exclude older diabetic patients from innovative programs to help them control blood sugar levels.

“It is important for individuals with diabetes to keep their blood sugar levels as close to the normal range as possible to prevent complications such as blindness, heart attacks and kidney failure,” said Ruth Weinstock, M.D, Ph.D., medical director of SUNY Upstate’s Joslin Diabetes Center and a co-principal investigator of the study. “We wanted to determine if depression prevents diabetic individuals, particularly older patients from underserved areas, from keeping their blood sugar levels under control, and if depression prevented them from benefiting from a home telemedicine program. This intervention helped them improve their diabetes control by having home televisits with a nurse case manager, and sending their blood sugar and blood pressure readings electronically. We found that the presence of depression didn’t impair their ability to benefit from participation in this program.”

However, depression may influence other areas of a diabetic patient’s life, resulting in a diminished quality of life. “Our next step is to evaluate the impact of depression on outcomes other than control of blood sugar levels,” said Paula Trief, Ph.D., principal investigator of the study and professor of medicine and psychiatry and behavioral sciences at SUNY Upstate. “We need to discover if depression prevents diabetic patients from adhering to their treatment programs such as those related to diet and exercise, or if it affects their personal relationships. If so, we believe that interventions should modified to treat the depression as well.”

The study “Depression and Glycemic Control in Elderly Ethnically Diverse Patients with Diabetes: the IDEATel Project” followed 1,665 diabetic elderly patients who are participating in IDEATel (Informatics for Diabetes Education and Telemedicine), a multi-site project funded through a $28 million grant from the Centers for Medicare and Medicaid Services (CMS). Researchers analyzed data that included baseline demographics, such as age, sex, race/ethnicity, marital status, insulin use, years of education, years of diabetes and pack-years smoked, and measures of blood sugar control, comorbidity, diabetes symptom severity, functional disability and depression and one-year blood sugar control. In addition to Trief and Weinstock, SUNY Upstate coinvestigators included Roberto Izquierdo, M.D., and Philip C. Morin of the Joslin Diabetes Center.

IDEATel, the largest civilian telemedicine effort ever funded by the federal government, uses Internet technology to increase access to healthcare of underserved rural and inner-city resident with diabetes. The project seeks to establish the healthcare and cost-effectiveness of telemedicine, so that CMS can set standards for reimbursement of teleheath services. SUNY Upstate’s Joslin Diabetes Center leads the rural upstate New York IDEATel consortium sites. Columbia University leads the NYC urban sites. Weinstock serves as the principal investigator of SUNY Upstate’s participation in IDEATel.

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