Patients who were not depressed also were divided into nortriptyline and placebo groups. Then the patients were followed for eight weeks. This was the first placebo-controlled study to establish that it is possible to treat depression in diabetic patients. The study was supported by a grant from the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health, and in part by the Sandoz Corp., which provided the nortriptyline. Better Compliance Depression has a negative influence on quality of life for anyone, but it can cause additional problems for patients with diabetes because it is closely associated with poor glucose control.
Depression also is linked to poor compliance with diabetes treatment.
Depressed patients may not comply with their treatment regimens, or perhaps depression may cause changes in neuroendocrine function, making blood sugar especially difficult to control. Because depression makes it hard for a person to get anything done, it makes sense that the disorder might interfere with measuring blood glucose levels and exercising, watching one's diet or taking insulin. Therefore, treating depression could enable a diabetic patient to better manage diabetes. But Lustman says the study showed that better compliance alone did not explain the better blood sugar control. The researchers used electronic monitoring devices to determine whether the subjects took their medication.