Introduction
Diabetes, inflammation, depressive symptoms, depression, Depression, diabetes
INFLAMMATION, SECONDARY, INSULIN RESISTANCE, DIABETES, TYPE 2 DIABETES, DIABETES
Depression is associated with increased risk for type 2 diabetes, with relative risks (RR) ranging from 1.26 to 1.60The Diabetes Prevention Program (DPP;Cambodian refugees, who were resettled in the USA approximately 40 years ago fleeing the genocidal Pol Pot regime, have age- and sex-adjusted rates of type 2 diabetes more than double the US national averageAny diabetes prevention interventions for this group must take into account Cambodians’ significant barriers to lifestyle change including high rates of historic traumaThis paper reports the outcomes of a randomized, controlled trial of culturally derived diabetes prevention interventions for Cambodian Americans with depression, i.e., those with elevated symptoms of depression and/or taking antidepressant medication. We compared three arms: lifestyle vs lifestyle plus medication therapy management vs social services. Given the aforementioned evidence regarding the role of lifestyle in both glycemic status and depression, we hypothesized that, relative to social services, participants receiving lifestyle intervention would show improved depressive symptoms, HbA1c, and insulin resistance at post-intervention. Further, given evidence regarding the role of psychoactive medication in both glycemic status and depression, we hypothesized that the combined arm (lifestyle plus medication therapy management) would show more improvement in these primary outcomes than the lifestyle-only arm. In secondary analyses we examined effects on inflammation and stress hormones.