"The association between depression and type 2 diabetes is well documented, but clinical trials of either medication or psychological treatment for depression have had mixed or negative effects on adherence to treatment programs," says Steven Safren, PhD, ABPP, director of Behavioral Medicine in the MGH Department of Psychiatry and lead author of the report in the March issue of Diabetes Care. "In this study we adapted our approach that has improved treatment adherence among HIV/AIDS patients by addressing both depression and treatment self-management skills."

The current study enrolled 87 adults whose type 2 diabetes was poorly controlled despite treatment with oral medications and who also met criteria for a diagnosis of depression. At the outset of the trial, all participants received an enhanced version of usual diabetes self-care counseling -- including meetings with a nurse educator to set goals for blood sugar monitoring, with a dietitian to set dietary and exercise goals, and with a counselor to set strategies for meeting those goals and other medical recommendations.