TY - JOUR
T1 - A Randomized Controlled Trial to Prevent Depression and Ameliorate Insulin Resistance in Adolescent Girls at Risk for Type 2 Diabetes
AU - Shomaker, Lauren B.
AU - Kelly, Nichole R.
AU - Pickworth, Courtney K.
AU - Cassidy, Omni L.
AU - Radin, Rachel M.
AU - Shank, Lisa M.
AU - Vannucci, Anna
AU - Thompson, Katherine A.
AU - Armaiz-Flores, Sara A.
AU - Brady, Sheila M.
AU - Demidowich, Andrew P.
AU - Galescu, Ovidiu A.
AU - Courville, Amber B.
AU - Olsen, Cara
AU - Chen, Kong Y.
AU - Stice, Eric
AU - Tanofsky-Kraff, Marian
AU - Yanovski, Jack A.
N1 - Publisher Copyright:
© 2016, The Society of Behavioral Medicine.
PY - 2016/10/1
Y1 - 2016/10/1
N2 - 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).
AB - 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).
KW - Adolescence
KW - Depression
KW - Insulin resistance
KW - Randomized controlled trial
KW - Type 2 diabetes
UR - http://www.scopus.com/inward/record.url?scp=84975467879&partnerID=8YFLogxK
U2 - 10.1007/s12160-016-9801-0
DO - 10.1007/s12160-016-9801-0
M3 - Article
C2 - 27333897
AN - SCOPUS:84975467879
SN - 0883-6612
VL - 50
SP - 762
EP - 774
JO - Annals of Behavioral Medicine
JF - Annals of Behavioral Medicine
IS - 5
ER -