WELLBUTRIN FOR DEPRESSION IN DIABETIC PATIENTS

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Diabetes is present in approximately 20,000,000 adults and is a leading cause of morbidity and mortality. Hyperglycemia is the principal cause of the neuropathic, micro- and macrovascular complications of diabetes; accordingly maintenance of normoglycemia has long been the focus of diabetes therapy. However, even with aggressive treatment, glycemic control sufficient to prevent the development of diabetes complications is rarely achieved (1,2). This has intensified the search for modifiable factors that could improve the course of diabetes, and depression management may be one of these factors. Clinical depression, present in approximately 25% of patients with diabetes (type 1 or type 2), is associated with hyperglycemia and with increased risk for complications, particularly macrovascular disease. These observations led to a series of clinical trials to determine whether these associations could me manipulated through depression treatment. These studies indicate that improvement in depression is associated with short-term improvement in glycemic control and insulin resistance; however, the effects of treatment on mood and glucose regulartion are not always parallel nor uniformly prodiabetic. If as happens the depression intervention induces weight gain, a seperate factor promoting hyperglycemia and insulin resistance, the overall effects of depression therapy in the face of diabetes would be devalued. As yet, and agent having concomitant positive and durable effects on depression, glycemic control, and weight is desirable but has not yet been identified.