Exploring the feasibility, acceptability and effectiveness of screening and management for depressive symptoms and diabetes distress for the prevention of deteriorating glycaemic control in people with Type 2 diabetes

Principal Investigator:  Professor Kamlesh Khunti

Other Key Staff: Professor Melanie Davies, Dr Noelle Robertson, Dr Trevor Friedman, Navneet Aujla, Professor Frank Snoek, Nicola Perrin

Partners Involved: Leicestershire Partnership NHS Trust, University of Leicester

Summary:
Type 2 Diabetes is a common long-term condition that results in raised blood sugar levels, which can be seriously harmful to a person’s health. Depression is a mental health disorder that results in low mood and reduced motivation. People with diabetes may also be subject to ‘distress’ related to their diabetes. People with diabetes plus depression or distress are often less able to maintain control over their diabetes, resulting in them getting serious complications, such as heart disease, earlier. Early recognition of depression and distress in people with diabetes can often be difficult for GPs.

This project will enable us to complete some development work that will help design ways of screening people with diabetes for depression and distress, and then provide an effective management programme.  The proposed work includes systematic searches of what has already been written about the topic of ‘distress’ and conducting an interview study to explore the views and experiences of patients and healthcare professionals who have, or are involved in the care of, Type 2 Diabetes. This work will lead to developing a screening and management programme for people with diabetes and depression and/or distress, which will be suitable for delivery within general practices, and a feasibility trial to explore how effective the programme would be. The studies will be conducted across Leicester City, Leicester County and Rutland and NHS Northamptonshire primary care trusts. The programme will adopt a ‘collaborative care’ approach, involving professionals from various specialities working together to identify and manage people with depression and/or distress, though a programme of care tailored to the specific needs of the individual. The care programme will also adopt an approach that will offer people with the lowest intensity of treatment first, and then higher intensities if individuals do not appear to be gaining benefits from the earlier stages. This approach is known as ‘stepped care’.

Aims:

• To determine the feasibility and acceptability of a screening and management strategy for co-morbid depression and diabetes distress in a primary care population with Type 2 diabetes.

  To develop a screening and management programme, using a ‘collaborative care’ approach, for routine implementation in primary care, and assess the extent to which there is improvement in depression, distress and glycaemic control.

  To inform the development of a randomised controlled trial to assess the clinical and cost effectiveness of a definitive intervention for screening and management of depressive symptoms and diabetes distress in people with Type 2 diabetes, with a view to preventing the long-term worsening glycaemic control.

Further Information:
For more information about this project please contact  This e-mail address is being protected from spambots. You need JavaScript enabled to view it or This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Start Date: 09/01/2010                                                                      Expected End Date: 31/12/2013

Project Outcomes:
Overall, the project work has the short-term benefit of identifying depression and/or distress in people with diabetes and the long-term potential to prevention people with co-morbid depression from having worsening control over their diabetes. Thus delaying the onset of serious complications, for example heart disease, and saving costs for the NHS.