Darunee keawhawong
Darunee keawhawong

Darunee keawhawong

Darunee keawhawong


Darunee keawhawong

Location: Udrontanee, Thailand

Member Since: August 2012

Open for read requests: Yes

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Can Lifestyle Interventions Do More Than Reduce Diabetes
Risk? Treating Depression in Adults With Type 2 Diabetes
With Exercise and Cognitive Behavioral Therapy
Mary de Groot & Todd Doyle & Michael Kushnick &
Jay Shubrook & Jennifer Merrill & Erin Rabideau &
Frank Schwartz
Published online: 15 February 2012
# Springer Science+Business Media, LLC 2012
Abstract The epidemic of metabolic syndrome, prediabetes,
and type 2 diabetes is global in scope and comprehensive
in its impact on individuals, health care systems, and
societies. One in four patients with diabetes will experience
depression in their lifetime. Comorbid depression is associated
with poorer outcomes, greater functional disability, and
early mortality. Prior studies have demonstrated beneficial
effects of exercise as an efficacious form of treatment for
depression in the general population. Few studies have
evaluated this strategy in patients with prediabetes or type
2 diabetes. Program ACTIVE (Appalachians Coming Together
to Increase Vital Exercise) was designed to treat
depression among adults with type 2 diabetes by pairing
aerobic activity with individual cognitive behavioral therapy.
This combination treatment approach has been shown to
be feasible to implement in a rural environment and promising
in terms of depression, diabetes, and cardiovascular
outcomes. Data from this study suggest that exercise can be
used to achieve multiple benefits for adults with type 2
diabetes. Future work to compare this approach to singular
treatment strategies for adults at risk for type 2 diabetes is
Keywords Depression . Type 2 diabetes . Exercise .
Cognitive behavioral therapy. Lifestyle interventions
Type 2 diabetes mellitus (T2DM) represents a growing
burden to the health, welfare, and productivity of individuals
in underserved urban and rural communities [1, 2].
Poverty, socioeconomic stress, and sedentary lifestyle have
been shown to increase the risk for the development of
obesity and T2DM [2, 3] as well as morbidity and premature
mortality of T2DM [4–6].
Patients with T2DM are two times more likely to experience
depression in their lifetime than their peers without
diabetes, having an overall prevalence ranging from 25% to
27% [7]. This rate exceeds those found in the general
population and is particularly troublesome when diabetes
outcomes and associated costs are considered.
Depressive symptoms have been shown to be associated
with worsened blood glucose levels [8] and diabetes
M. de Groot
Department of Medicine, Indiana University School of Medicine,
Indianapolis, IN, USA
T. Doyle : J. Merrill : E. Rabideau
Department of Psychology, Ohio University,
Athens, OH, USA
M. Kushnick
School of Health Sciences and Wellness, College of Health
Sciences and Professions, Ohio University,
Athens, OH, USA
J. Shubrook
Department of Family Medicine,
Ohio University College of Osteopathic Medicine,
Athens, OH, USA
F. Schwartz
Department of Specialty Medicine,
Ohio University College of Osteopathic Medicine,
Athens, OH, USA
M. de Groot (*)
Department of Medicine, Division of Endocrinology and
Metabolism, Diabetes Translational Research Center,
410 West 10th Street,
Indianapolis, IN 46202, USA
e-mail: mdegroot@iupui.edu
Curr Diab Rep (2012) 12:157–166
DOI 10.1007/s11892-012-0261-z



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