The first known study to examine the relationship between diabetes and mortality in a depression intervention trial appears in the December issue of Diabetes Care.

Depression is common among people with diabetes and contributes to issues with medication and diet adherence, and also leads to an overall reduced quality of life, says lead author, Hillary R. Bogner, MD, MSCE, Assistant Professor, Department of Family Practice and Community Medicine at Penn.

The multi-site, practice-randomized controlled trial was conducted in 20 primary care practices in New York City, Philadelphia, and Pittsburgh. A total of 584 participants 60 “ 94 years of age were identified through a depression screening, and of these participants, 123 reported a history of diabetes. The practices were randomly assigned to usual care, or a depression care management intervention, which involved a depression care manager who worked with the primary care provider to recommend treatment for depression and assist patients with treatment adherence.

At follow-up, 110 depressed patients had died. Depressed, older adults with diabetes who were in practices randomized to depression care management were less likely to have died at the end of the 5-year follow-up than were depressed, older adults with diabetes who received usual care. The authors note that they believe these findings support the integration of depression evaluation and treatment with diabetes management in primary care.

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The research team, led by Dr. Kirsten Bibbins-Domingo, an assistant professor in medicine, epidemiology and biostatistics at UCSF, say unless something is done, current adolescent overweight will have a substantial effect on public health far into the future.

The model estimated more than 100,000 extra cases of heart disease by 2035, which is a 16 percent increase over today ™s figures, and a rise in obesity-related CHD deaths by as much as 19 percent.

Dr. Bibbins-Domingo says one of the major health risks for an obese person is becoming diabetic; diabetes increases the risk of heart disease and many other health complications and it is very difficult to lower the likelihood of getting diabetes once a person is obese.

Experts agree and say childhood obesity may shorten life expectancy in the United States by 2 to 5 years by 2050 which equates to the effect of all cancers combined, with catastrophic effects in terms of costs, diminished productivity and physical and psychological disabilities.

The studies are published in the New England Journal of Medicine.