CBT improves diabetes tx adherence

HealthDay News — Cognitive behavioral therapy is associated with enduring benefits for diabetes self-management and glycemic control among adults with type 2 diabetes and depression, according to a study published in Diabetes Care.

Among 87 adults with both conditions, those assigned to cognitive behavioral treatment (CBT) demonstrated greater oral medication adherence (20.7%; P=0.000), better self-monitoring of blood glucose (30.2%; P=0.000) and lower hemoglobin A1c (0.72 units lower; 95% CI: 0.29–1.15, P=0.001) four months after acute treatment, Steven A. Safren, PhD, from Massachusetts General Hospital in Boston, and colleagues reported.

All participants had unipolar depression and uncontrolled type 2 diabetes and received treatment as usual, including counseling on medication adherence, self-monitoring of blood glucose and lifestyle counseling. Participants randomly assigned to the CBT arm also received nine to 11 sessions for adherence and depression.

Patients in the CBT group also had lower depression scores on the Montgomery-Asberg Depression Rating Scale (6.44 points; P=0.002); lower Clinical Global Impression (0.74 points; P=0.01) compared with the control group.

At eight- and 12-month follow-up, improvements in medication adherence (24.3%; P = 0.001), blood glucose self monitoring (16.9%; P = 0.043) and hemoglobin A1c (0.63 units lower; P=0.03) observed in the CBT group remained.

Some evidence was seen for continued improvement of depression post-treatment, with no between-group differences.

“CBT [for adherence and depression] is an effective intervention for adherence, depression and glycemic control, with enduring and clinically meaningful benefits for diabetes self-management and glycemic control in adults with type 2 diabetes and depression,” the researchers wrote.