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Lippincotts Case Manag. 2004 Jul-Aug;9(4):177-83.

The relationship between diabetes and depression: improving the effectiveness of case management interventions.

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Ambulatory Quality Improvement Programs at Health Services Advisory Group, Arizona State Diabetes Collaborative, USA.


Diabetes places an immense burden on U.S. healthcare delivery systems. The Centers for Disease Control and Prevention estimates the economic impact of diabetes at nearly 100 billion dollars a year. Diabetes affects 17 million people in the United States and ranks as the sixth leading cause of death. Diabetes is among the most psychologically and behaviorally demanding chronic medical illnesses and the presence of diabetes doubles the odds of comorbid depression. In addition, recent research demonstrates that depressive symptoms serve as a predictor of type 2 diabetes. Case managers should maintain a high index of suspicion for the possibility of depression in chronically ill clients, as the severity of depressive symptoms is associated with poorer treatment adherence and higher healthcare costs. Three valid and reliable tools available to support depression screening in the case management setting are presented.

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