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Erschienen in: Annals of Behavioral Medicine 5/2016

22.06.2016 | Original Article

A Randomized Controlled Trial to Prevent Depression and Ameliorate Insulin Resistance in Adolescent Girls at Risk for Type 2 Diabetes

verfasst von: PhD Lauren B. Shomaker, PhD Nichole R. Kelly, BA Courtney K. Pickworth, MS Omni L. Cassidy, MS Rachel M. Radin, MS Lisa M. Shank, MS Anna Vannucci, BS Katherine A. Thompson, BS Sara A. Armaiz-Flores, MS, CRNP Sheila M. Brady, MD Andrew P. Demidowich, MD Ovidiu A. Galescu, PhD, RD Amber B. Courville, DrPh Cara Olsen, PhD Kong Y. Chen, PhD Eric Stice, PhD Marian Tanofsky-Kraff, MD, PhD Jack A. Yanovski

Erschienen in: Annals of Behavioral Medicine | Ausgabe 5/2016

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Abstract

Background

Prospective data suggest depressive symptoms worsen insulin resistance and accelerate type 2 diabetes (T2D) onset.

Purpose

We sought to determine whether reducing depressive symptoms in overweight/obese adolescents at risk for T2D would increase insulin sensitivity and mitigate T2D risk.

Method

We conducted a parallel-group, randomized controlled trial comparing a 6-week cognitive–behavioral (CB) depression prevention group with a 6-week health education (HE) control group in 119 overweight/obese adolescent girls with mild-to-moderate depressive symptoms (Center for Epidemiological Studies—Depression Scale [CES-D] ≥16) and T2D family history. Primary outcomes were baseline to post-intervention changes in CES-D and whole body insulin sensitivity index (WBISI), derived from 2-h oral glucose tolerance tests. Outcome changes were compared between groups using ANCOVA, adjusting for respective baseline outcome, puberty, race, facilitator, T2D family history degree, baseline age, adiposity, and adiposity change. Multiple imputation was used for missing data.

Results

Depressive symptoms decreased (p < 0.001) in CB and HE from baseline to posttreatment, but did not differ between groups (ΔCESD = −12 vs. −11, 95 % CI difference = −4 to +1, p = 0.31). Insulin sensitivity was stable (p > 0.29) in CB and HE (ΔWBISI = 0.1 vs. 0.2, 95 % CI difference = −0.6 to +0.4, p = 0.63). Among all participants, reductions in depressive symptoms were associated with improvements in insulin sensitivity (p = 0.02).

Conclusions

Girls at risk for T2D displayed reduced depressive symptoms following 6 weeks of CB or HE. Decreases in depressive symptoms related to improvements in insulin sensitivity. Longer-term follow-up is needed to determine whether either program causes sustained decreases in depressive symptoms and improvements in insulin sensitivity.

Trial Registration Number

The trial was registered with clinicaltrials.gov (NCT01425905).
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Metadaten
Titel
A Randomized Controlled Trial to Prevent Depression and Ameliorate Insulin Resistance in Adolescent Girls at Risk for Type 2 Diabetes
verfasst von
PhD Lauren B. Shomaker
PhD Nichole R. Kelly
BA Courtney K. Pickworth
MS Omni L. Cassidy
MS Rachel M. Radin
MS Lisa M. Shank
MS Anna Vannucci
BS Katherine A. Thompson
BS Sara A. Armaiz-Flores
MS, CRNP Sheila M. Brady
MD Andrew P. Demidowich
MD Ovidiu A. Galescu
PhD, RD Amber B. Courville
DrPh Cara Olsen
PhD Kong Y. Chen
PhD Eric Stice
PhD Marian Tanofsky-Kraff
MD, PhD Jack A. Yanovski
Publikationsdatum
22.06.2016
Verlag
Springer US
Erschienen in
Annals of Behavioral Medicine / Ausgabe 5/2016
Print ISSN: 0883-6612
Elektronische ISSN: 1532-4796
DOI
https://doi.org/10.1007/s12160-016-9801-0