It takes more than physicians to treat a patient with multiple chronic diseases like diabetes mellitus and heart disease. A new trial suggests a nurse who acts like a coordinator for the health care intended for a patient can help improve the outcomes dramatically.
Patients with diabetes mellitus and or heart disease are at higher risk of depression. When depression strikes, the medical treatments would not be as effective.
The trial led by Dr. Wayne J. Katon and colleagues at University of Washington found patients who received care from nurses who worked with patients and physicians to manage the care for depression and diabetes and heart disease had better outcomes.
The trial reported in the Dec 30, 2010 issue of New England Journal of Medicine compared two groups of patients, one received the standard care without any so called Teamcare, while the other received a Teamcare intervention.
In the teamcare intervention, a nurse helped monitor disease control like cholesterol, blood pressure, blood sugar and depression and worked closely with each patient’s primary physicians to help patients use medications effectively.
At one year of the trial, those receiving the TEAMcare were found less depressed and had their blood sugar, cholesterol and blood pressure better controlled, compared with other patients with depression, diabetes mellitus and heart disease.
The patients who received the Teamcare intervention were reportedly more likely to be satisfied with the quality of life and treatments for depression and either diabetes mellitus, heart disease or both. These patients more likely had timely adjustments for blood sugar levels, high blood pressure, cholesterol and medications.
Mediterranean diet may help prevent diabetes, heart disease and depression.
A study published in the Oct 13, 2001 issue of Diabetes Care suggests eating Mediterranean diet can reduce the risk of developing diabetes significantly.
The study found those who adhered most closely to the Mediterranean diet were 52 percent less likely to develop diabetes, compared with those who adhered least to the diet.
Salas-Salvadó J. of Universitat Rovira i Virgili in Reus, Spain and colleagues compared two groups of subjects following two Mediterranean diets, one with nuts at 30 grams per day and the other with olive oil at 1 liter per week, with those on a low-fat diet.
During the 4-year follow-up, incidence of diabetes in two Mediterranean diets was 10.1 percent and 11.0 percent respectively, compared to 17.9 percent among the controls.
Those who followed the Mediterranean diet were nearly 50 percent less likely to be diagnosed with diabetes mellitus and nuts and olive oil did not make any difference in terms of their influence on the incidence of diabetes.
The Mediterranean diet was inversely associated with diabetes incidence, but not linked with any significant changes in body weight or physical activity.
The researchers concluded “Mediterranean diets without calorie restriction appear to be effective in the prevention of diabetes in subjects at high cardiovascular risk.”
In the Dec 24, 2010 issue of Nutrition, Metabolism and Cardiovascular Disease, Menotti A and colleagues from Associazione per la Ricerca Cardiologica, Via Latina suggests that a healthy Mediterranean diet pattern protects against coronary heart disease or CHD.
The researchers analyzed data from 1139 men aged 45 to 64 years who were free of coronary events at baseline and followed for 40 years.
One unit of the Mediterranean Adequacy Index was associated with a 26 percent reduction in CHD mortality in 20 years and 21 percent in 40 years of follow-up.
Mediterranean diet may also reduce risk of depression, according to a study published in the Oct 2009 issue of Archives of General Psychiatry.
Could fish, which contains antidepressive vitamin D in fish oil, in the diet make any difference? Vitamin D defciency is linked with elevated risk of depression.
The study led by Sánchez-Villegas A and colleagues from University of Las Palmas de Gran Canaria, Spain followed 10094 initially healthy Spanish individuals in hopes to establish the association between use of Mediterranean diet and depression risk.
During a 4.4-year follow-up, 480 cases of depression were identified.
The researchers found those who adhered most closely to the Mediterranean diet were up to 42 percent less likely to be diagnosed with depression, compared with those who adhered least to the diet.