title: Glycemic control improvement through treatment of depression using antidepressant drugs in patients with diabetes mellitus type 1.
abstract: OBJECTIVE
  Depression is a common disorder among diabetic patients and affects negatively the treatment of their basic disease. The aim of the study was to assess, whether antidepressant medication could positively influence glycemic control of diabetes type 1 in depressive or anxious patients.
  
  
  METHODS
  A six-month, double-blinded, randomized, placebo-controlled study was performed to investigate the reaction of type 1diabetic patients (n=21) to treatment of depression and anxiety symptoms using antidepressant drug sertraline. The patients were given sertraline (100 mg/day) or placebo. The evolution of mental change was assessed using Zung Self-Rating Depression Scale (SDS), Hamilton Anxiety Rating Scale (HAMA) and Hamilton Depression Rating Scale (HAMD) along with development of somatic parameters commonly assessed in diabetic patients, especially glycosylated hemoglobin, insulin dose and body weight. The level of active substance in serum of the patients was also measured.
  
  
  RESULTS
  Mental state improved at the level of statistical significance of p<0.001 in both patients using antidepressant and placebo. From somatic parameters, body weight and systolic blood pressure increased statistically significantly also in both groups of patients.
  
  
  CONCLUSIONS
  The mental state of most patients who successfully completed the study improved regardless of the fact if they were using antidepressant or placebo. No statistically significant connections between the mental and somatic changes were found. This finding points out to the placebo effect of the medication, to the importance of a contact with patients, but also to the need to concentrate on their mental state.
authors.affiliation: Department of Psychiatry, University Hospital, Charles University in Pilsen, Alej svobody 80, Pilsen, Czech Republic. komorousovaj@fnplzen.cz
authors.forename: Jana
authors.initials: J
authors.lastname: Komorousova
authors.forename: Jiri
authors.initials: J
authors.lastname: Beran
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Rusavy
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Jankovec
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001007:Anxiety / Q000188:drug therapy* / Q000209:etiology; D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure / Q000187:drug effects; D001835:Body Weight / Q000187:drug effects; D003863:Depression / Q000188:drug therapy* / Q000209:etiology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D004311:Double-Blind Method; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007328:Insulin / Q000008:administration & dosage; D008297:Male; D020280:Sertraline / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin; D020280:Sertraline