Since last Friday, I have interviewed five more patients with my survey, the results of which are compiled below.
At a level of 11.50% (see Figure 5), Patient 6 has the highest HbA1c level out of all subjects surveyed to date. Consistent with what I mentioned in my last post (how Type 1 diabetics would likely have a higher HbA1c than Type 2 diabetics, since Type 1 diabetes is more difficult to control), Patient 6 is a Type 1 diabetic. Their PHQ-9 score of 9, one point short of a diagnosis of depression (according to DSM-IV), could be indicative of the patient's frustration and feelings of fatigue that stem from their uncontrolled diabetes.
Definitely the most interesting data I have collected to date comes from Patient 8. Patient 8 has already been diagnosed as depressed — this is consistent with their high PHQ-9 score of 12. Additionally, Patient 8 is a Type 1 diabetic. Yet, Patient 8's HbA1c is at a very healthy 6.30%. They don't even meet the ADA diagnostic criteria for diabetes!
How is it that a patient who is diagnosed with Type 1 diabetes and a DSM-IV depressive disorder can maintain such a low level of glycemic control (blood sugar control) that is inconsistent with essentially all other diagnosed diabetics?
This brings us to the extensive list of medications that even I have ignored thus far. Patient 8 is on Sertraline HCl, which is in a class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs). Perhaps Patient 8's treatment for depression has enabled his excellent glycemic control. This is also consistent with my main hypothesis of how diabetes and depression work in a circular fashion — where each of these chronic conditions often impairs the proper treatment of the other (see FIgure 3 in "Which Comes First?"); if this is the case, it follows that treating one of these conditions would help treat the other, as it appears with Patient 8.
As always, thanks for reading!
Lalani.
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| Figure 5. |
Definitely the most interesting data I have collected to date comes from Patient 8. Patient 8 has already been diagnosed as depressed — this is consistent with their high PHQ-9 score of 12. Additionally, Patient 8 is a Type 1 diabetic. Yet, Patient 8's HbA1c is at a very healthy 6.30%. They don't even meet the ADA diagnostic criteria for diabetes!
How is it that a patient who is diagnosed with Type 1 diabetes and a DSM-IV depressive disorder can maintain such a low level of glycemic control (blood sugar control) that is inconsistent with essentially all other diagnosed diabetics?
This brings us to the extensive list of medications that even I have ignored thus far. Patient 8 is on Sertraline HCl, which is in a class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs). Perhaps Patient 8's treatment for depression has enabled his excellent glycemic control. This is also consistent with my main hypothesis of how diabetes and depression work in a circular fashion — where each of these chronic conditions often impairs the proper treatment of the other (see FIgure 3 in "Which Comes First?"); if this is the case, it follows that treating one of these conditions would help treat the other, as it appears with Patient 8.
As always, thanks for reading!
Lalani.
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