Recognizing and treating depression in patients with diabetes.

Diabetes doubles the risk for depression, which in turn may interfere with effective diabetes self-management, and is associated with hyperglycemia and with increased risk for diabetes complications. Despite its relevance to the course of diabetes and its chronic character, depression is recognized and treated appropriately in fewer than 25% of depressed diabetic patients. The authors discuss the use of screening tools to assist primary care providers in identifying depressed diabetic patients, as well as the application of a chronic care model of depression management. Data from controlled trials are limited but promising. They suggest that pharmacologic and psychological approaches are effective in the face of diabetes, and that successful treatment also produces improvements in glycemic control, overall functioning, and quality of life.