Remember that movie with Billy Crystal and Robert De Niro, Analyze This? Well we all don't have super-risky mobster lifestyles to induce depression like Paul Vitti's, but according to a new study of depressed type 2 diabetics -- depression has a negative impact on blood sugar control.

Researchers treated 93 patients with type 2 diabetes and depression with the antidepressant bupropion (Wellbutrin). They chose the drug because it is capable of reducing depression and weight simultaneously. The hypothesis behind the treatment was mood enhancement and weight reduction would, in fact, improve blood sugar control. (Always a gold star day in my book!) The results were documented in the March issue of Diabetes Care, and showed that antidepressant treatment produced benefits beyond just mood improvement. Patients also lost weight, improved self-management of their diabetes, and improved their A1c levels.

In the 6 months following the conclusion of the study, depression improvement predicted maintenance of improved blood sugar control. This confirms the research hypothesis that depression improvement can produce better blood sugar control, independent of weight loss and overall diabetes management. The importance of weight-independent physiological factors like insulin sensitivity and inflammation improve during depression relief and contribute to better long-term control of diabetes.

The moral of this story? You tell me. I spotlight the research - I like it when you guys give me answers.

What increases bone density, promotes digestive health, helps keep kids healthy, and benefits the management of diabetes? Here's a hint, it sounds like the lifeblood treatment for type 1 diabetes - insulin - but the name of this goodie is inulin. Inulin in foods provides both bulk and sweetness without causing a rise in glucose levels.

Inulin is a natural dietary fiber found in over 35,000 common foods like artichokes, asparagus, onions, garlic, raisins and bananas. As an undigested fiber, it has no effect on blood glucose levels. It has a zero Glycemic Index. You could easily find it in your grocer's refrigerated section in Stonyfield Farm yogurts. Their version of inulin comes from chicory roots. Amazing all the places this ingredient naturally derives!

It is used increasingly in foods, because it has excellent nutritional and functional characteristics. Inulin can be used to replace sugar, fat, and flour. For the masses concerned with nutrition-labels, it contains one-third to one-fourth the food energy of sugar or other carbohydrates and one-sixth to one-ninth the food energy of fat. I'm curious to see what it tastes like, aren't you? From ignorant experience (uninformed of the artificial sweeteners used) I enjoy Stonyfield yogurts. I'll have to try another brand name with inulin on for size. Breaking news!! I just checked the ingredients in my newest dopamine-boosting fix: Trader Joe's low-glycemic dark chocolate. Golly gee-- sure enough inulin is on the list. I'm so in love with this dark chocolate because it really has such an insignificant affect on my blood sugar. Ultimate kudos to Ramsey, the creator of Miracle Muffins, for this sweet trinket of knowledge on artificial sweeteners!!

The results of this study do not surprise me at all. Researchers have found that psychosocial factors like cynical distrust, chronic stress and depression, may be associated with higher levels of inflammatory markers. These inflammatory markers are related to an increased risk for cardiovascular disease, the leading cause of premature death among people with diabetes.

The study included 6,814 men and women between the ages of 45 to 84. Participants were assessed for their levels of depression, chronic stress and cynical distrust. Blood samples obtained at the start of the study were analyzed for markers for inflammation. The researchers found associations between all three psychosocial factors and inflammatory markers.

A high stress lifestyle may increase the chance that an individual engages in social behaviors that increase inflammatory markers. The same high stress lifestyle may contribute to obesity and related metabolic problems. Furthermore, socioeconomic position is likely to be a precursor to psychosocial characteristics. True. But let's not wager our lives on a dollar-denominated scale. Consider the Chinese proverb, those who know when they have enough are rich. Now ask yourself where you stand in the socioeconomic parade. If you put it that way - I'm on easy street! Too bad it's in the wrong neighborhood.

Researchers found that using a systematic approach for the treatment of depression in diabetics will not increase health care spending, and might actually decrease the overall costs.

Researchers evaluated the cost and cost-effectiveness of a systematic depression treatment program versus the usual care for 329 outpatients with diabetes and depression. The intervention involved specialized nurses who provided a 12-month stepped-care depression treatment program using psychotherapy or antidepressant drugs or both. Systematic depression treatment significantly reduced the patients' average depression scores after 6 and 12 months, and these improvements were maintained at 24 months.

Outpatient depression treatment costs were approximately $700 higher in the intervention group during the first year, the results indicate. However the general medical outpatient costs in this group were lower, and offset most of the difference. During the second year, the approximately $100 in higher outpatient depression treatment costs in the intervention group was more than offset by lower outpatient costs of approximately $1400.

The study was designed with the hope of alleviating human suffering caused by diabetes. If reducing the burden of suffering also reduces costs of care, then depression management programs should be routinely integrated into diabetes care. Preempt this mission with the fact that the systematic depression treatment programs were associated with an increase of 61 depression-free days and an estimated cost savings of $300 - that's a monthly stipend of 20% more Happy Days and a half tank of gas. That'll give you something to smile about!

A study outlined in the American Journal of Clinical Nutrition examined the psychosocial consequences of weight reduction, asking the question -- how much weight loss is enough?

The psychosocial effects of weight reduction showed an association with improvements in mood in significantly obese individuals who are treated by diet and lifestyle modification. Exercise is associated with modest but long-term weight losses and with improvements in mood and physical health. The recommendation that overweight Americans lose weight should be prefaced with efforts to promote healthier attitudes toward weight and shape. A 10% reduction in initial weight correlates with improvements in psychosocial functioning. Even patients with just a 5% reduction in body weight report improvements in mood. They feel better as a result of taking charge of their eating and exercise habits and, ultimately, their weight.

As a footnote: please don't read this blog and walk-away thinking the message is lose some weight, Fatty. I'm a self-professed Pork Chop in hot pursuit of a dopamine deluge. I know when I'm surging with happiness, food is the furthest thing from my mind. I'm looking for the map to this euphoric destination. The minute I find it-- you'll have directions, too!