Clinical Research in Comorbid Diabetes and Depression

糖尿病和抑郁症共病的临床研究

• 批准号: 6752769
• 负责人: PATRICK J LUSTMAN
• 金额: $ 11.92万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-07-01 至 2006-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6752769
• 关键词: clinical research; comorbidity; depression; disease /disorder proneness /risk; human subject; noninsulin dependent diabetes mellitus; outcomes research

An NIDDK K24 award is requested to provide support for Patrick J. Lustman, Ph.D., to enhance a program of research and mentoring in Comorbid Diabetes and Depression. Diabetes affects 16 million Americans. Another 21 million have impaired glucose tolerance and are at risk for developing type 2 diabetes (T2DM). Major depression more than doubles the risk of T2DM even after controlling for other risk factors. Major depression is also present in 20% of patients with existing diabetes (type 1 or type 2), is associated with hyperglycemia, and conveys a significantly increased risk for each of the major complications of the metabolic disorder. The overall goals of the applicant's research are: 1) to elucidate the mechanisms by which depression affects the risk course, and outcome of diabetes; and 2) to determine whether and how depression treatment may improve glycemic control and the long-term course of diabetes. The proposal describes the applicant's current research, some ideas for future studies, and the career development and mentoring activities that are planned over the 5-year interval of the K24. Two NIH (NIDDK)-supported trials are ongoing. One is to determine if maintenance antidepressant treatment in diabetes will prevent or delay depression recurrence and produce durable improvements in glycemic control. The second is to establish if treatment of prepartum depression in diabetes will improve glycemic control and thereby decrease maternal and neonatal morbidity. Trainees will engage in these projects, take didactic coursework in clinical investigation, and complete a research proposal over the two-year training interval. A series of career development activities (for the PI) are also described that include additional training in structural equation modeling using SAS, and training in performing and interpreting intravenous glucose tolerance tests using minimal model analysis. K24 support will provide the applicant with the protected time needed to determine the utility of depression treatment in the everyday management of those living with diabetes and, in the process, to increase the mentoring of beginning clinical investigators in behavioral diabetes.

请求获得 NIDDK K24 奖项，为 Patrick J. Lustman 博士提供支持，以加强糖尿病和抑郁症共病的研究和指导计划。糖尿病影响着 1600 万美国人。另有 2100 万人糖耐量受损，有患 2 型糖尿病 (T2DM) 的风险。即使在控制其他危险因素后，重度抑郁症也会使 T2DM 的风险增加一倍以上。 20% 患有糖尿病（1 型或 2 型）的患者还存在重度抑郁症，它与高血糖有关，并导致代谢紊乱的每种主要并发症的风险显着增加。申请人研究的总体目标是：1）阐明抑郁症影响糖尿病风险过程和结果的机制； 2) 确定抑郁症治疗是否以及如何改善血糖控制和糖尿病的长期病程。该提案描述了申请人当前的研究、对未来研究的一些想法以及计划在 K24 的 5 年时间间隔内的职业发展和指导活动。两项由 NIH (NIDDK) 支持的试验正在进行中。一是确定糖尿病的维持性抗抑郁治疗是否可以预防或延缓抑郁症复发并持久改善血糖控制。第二个是确定糖尿病产前抑郁症的治疗是否会改善血糖控制，从而降低孕产妇和新生儿的发病率。学员将参与这些项目，参加临床研究的教学课程，并在两年的培训间隔内完成研究计划。还描述了一系列职业发展活动（针对 PI），包括使用 SAS 进行结构方程建模的额外培训，以及使用最小模型分析执行和解释静脉葡萄糖耐量测试的培训。 K24 支持将为申请人提供所需的受保护时间，以确定抑郁症治疗在糖尿病患者日常管理中的效用，并在此过程中加强对行为糖尿病初级临床研究人员的指导。