Use of antidepressants in patients with depression and comorbid diabetes mellitus: a systematic review

2016 ◽  
Vol 29 (3) ◽  
pp. 127-139 ◽  
Author(s):  
Subethini Roopan ◽  
Erik Roj Larsen
Keyword(s):  
Diabetes Mellitus ◽  
Maintenance Phase ◽  
Tricyclic Antidepressant ◽  
Favourable Effect ◽  
Strong Impact ◽  
Double Blind ◽  
Patients With Diabetes ◽  
Randomised Controlled ◽  
Almost All ◽  
Design And Methods

ObjectiveDepression may be difficult to treat and with comorbid diabetes mellitus (DM) it is an even bigger challenge. This article aims to evaluate antidepressants most suitable for patients with depression and comorbid DM.Design and methodsInitially we searched for randomised, controlled double-blind trials of treatment with antidepressants in depressed with DM but there were only a few studies and many of them were small trials. Thus, we decided to include studies that were not only randomised-controlled trials. In total, we ended up with 18 articles for our purposes.ResultsThe combination of depression and DM may be harmful as depression has a strong impact on psychosocial and medical outcomes in patients with DM. Almost all of the trials in this review showed a reduction in depressive symptoms after treatment with an antidepressant in the acute as well as during maintenance phase. It showed that depression improvement had a favourable effect on glycaemic control that was weight independent. Some studies included only subjects with minor depression or with suboptimal-controlled diabetes making it difficult to show an effect.ConclusionFrom these data, we will recommend choosing an selective serotonin reuptake inhibitor (SSRI) if possible to treat a depression among patients with diabetes. If treatment with a tricyclic antidepressant is needed, closer glycaemic monitoring is recommended. Bear in mind that there is a possible risk of hypoglycemia when using SSRIs. Agomelatine and bupropion have shown promising results, but need to be investigated in more trials.

scholarly journals E-healthcare for diabetes mellitus type 2 patients – a randomised controlled trial in Slovenia

2017 ◽  
Vol 56 (3) ◽  
pp. 150-157 ◽  
Author(s):  
Rade Iljaž ◽  
Andrej Brodnik ◽  
Tatjana Zrimec ◽  
Iztok Cukjati
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Nurse Practitioners ◽  
Controlled Trial ◽  
Control Group ◽  
Web Based ◽  
Patients With Diabetes ◽  
Randomised Controlled ◽  
Interventional Group

Abstract Background Telemonitoring and web-based interventions are increasingly used in primary-care practices in many countries for more effective management of patients with diabetes mellitus (DM). A new approach in treating patients with diabetes mellitus in family practices, based on ICT use and nurse practitioners, has been introduced and evaluated in this study. Method Fifteen Slovene family practices enrolled 120 DM patients treated only with a diet regime and/or tablets into the study. 58 of them were included into the interventional group, and the other 62 DM patients into the control group, within one-year-long interventional, randomised controlled trial. Patients in the control group had conventional care for DM according to Slovenian professional guidelines, while the patients in the interventional group were using also the eDiabetes application. Patients were randomised through a balanced randomisation process. Results Significant reductions of glycated haemoglobin (HbA1c) values were found after 6 and 12 months among patients using this eDiabetes application (p<0.05). Among these patients, a significant correlation was also found between self-monitored blood pressure and the final HbA1c values. Diabetic patients’ involvement in web-based intervention had only transient impact on their functional health status. Conclusion This eDiabetes application was confirmed to be an innovative approach for better self-management of DM type 2 patients not using insulin. Both a significant reduction of HbA1c values and a significant correlation between the average self-measured blood pressure and the final HbA1c values in the interventional group were found. Nurse practitioners – as diabetes care coordinators – could contribute to better adherence in diabetes e-care.

scholarly journals Dietary supplementation with n-3 PUFA does not promote weight loss when combined with a very-low-energy diet

2012 ◽  
Vol 108 (8) ◽  
pp. 1466-1474 ◽  
Author(s):  
Irene A. Munro ◽  
Manohar L. Garg
Keyword(s):  
Weight Loss ◽  
Controlled Trial ◽  
Weight Maintenance ◽  
Maintenance Phase ◽  
Fold Increase ◽  
Low Energy ◽  
Double Blind ◽  
Very Low Energy Diet ◽  
Randomised Controlled ◽  
Low Energy Diet

Obesity is associated with elevated levels of inflammation and metabolic abnormalities which are linked to CVD. The aim of the present study was to investigate whether long-chain n-3 PUFA (LCn-3PUFA), combined with a very-low-energy diet (VLED), facilitated weight loss and weight maintenance, and improvements in blood lipids and inflammatory mediators. This was a double-blind, randomised, controlled trial with two parallel groups. For 14 weeks, one group consumed 6 × 1 g capsules/d of monounsaturated oil (placebo group, PB), and the other group consumed 6 × 1 g capsules/d of LCn-3PUFA (fish oil group, FO), each comprising 70 mg EPA and 270 mg DHA. Both groups were on VLED for 4 weeks (n 14 PB, n 18 FO), which was then followed by 10 weeks of weight maintenance (n 12 PB, n 17 FO). Fasting blood samples, anthropometric measurements and 3 d food diaries were collected at baseline, at 4 and 14 weeks. A greater-than-2-fold increase occurred in plasma levels of EPA and DHA in the FO group (P < 0·001). At 4 weeks, the mean weight loss was − 6·54 (sd 2·08) kg ( − 6·9 %) for PB and − 6·87 (sd 1·83) kg ( − 7·7 %) for FO. At week 14, after the maintenance phase, there was a further mean decrease in weight, − 1·57 (sd 3·7) kg (1·85 %) for PB and − 1·69 (sd 2·32) kg ( − 1·9 %) for FO. Both groups experienced improved metabolic profiles and there was a significant reduction in fat mass for the FO group at week 14 but not for PB. However, it would appear that supplementation with LCn-3PUFA had no significant effect on weight loss or weight maintenance over the 14 weeks.

scholarly journals Effects of probiotics in patients with diabetes mellitus type 2: study protocol for a randomized, double-blind, placebo-controlled trial

Trials ◽  
2013 ◽  
Vol 14 (1) ◽  
pp. 195 ◽  
Author(s):  
Majed S Alokail ◽  
Shaun Sabico ◽  
Yousef Al-Saleh ◽  
Nasser M Al-Daghri ◽  
Khalid M Alkharfy ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Study Protocol ◽  
Diabetes Mellitus Type 2 ◽  
Controlled Trial ◽  
Diabetes Mellitus Type ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Patients With Diabetes

scholarly journals Contrast-induced nephropathy in cardiology practice: Risk factors and approaches to prevention

2012 ◽  
Vol 18 (3) ◽  
pp. 222-227
Author(s):  
YU. F. Salakhova ◽  
D. V. Duplyakov ◽  
E. R. Perunova ◽  
S. E. Burnazyan ◽  
E. I. Bazhenova ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Filtration Rate ◽  
Percutaneous Coronary Interventions ◽  
Contrast Induced Nephropathy ◽  
Gault Formula ◽  
Percutaneous Coronary ◽  
Initial Decrease ◽  
Patients With Diabetes ◽  
Design And Methods

Objective. To study the incidence and risk factors of contrast-induced nephropathy (CIN) resulted from percutaneous coronary interventions in cardiology practice. Design and methods. Retrospective analysis of 100 history cases of patients aged 37-73 years (mean age 56,1 ± 6,0 years) was preformed. 0mnipac-350 was used as a contrast agent during angiography. Glomerular filtration rate (GFR) was assessed by Cockroft-Gault formula before and 48 hours after the intervention. The patients were divided into 2 groups depending on the type of intervention: the first group included the patients with planned intervention and the second — with urgent endovascular intervention. Results. In the first group 3,0 % (n = 2) patients developed CIN, and one case was registered (2,95 %) in the second group. It developed in patients with initial decrease of GFR, in patients with diabetes mellitus and with the combination of both factors.

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