Our research program is focused the role of stress, depression and personality variables in the etiology and treatment of diabetes mellitus. We have recently finished a large clinical trial of stress-management in the treatment of type 2 diabetes that demonstrated that a brief, group, stress management intervention can improve long-term glycemic control in a large sample of patients with type 2 diabetes. In addition we have two other projects currently ongoing. The first is concerned with the impact of a cognitive behavioral program in the treatment of diabetes. Extensive literature documents increased incidence of depression in patients with diabetes mellitus. However, the degree to which the treatment of depression impacts on diabetes control is not clear. Some investigators have found a strong association between depression and diabetes control, while others have found a week assocation. A review of existing literature as well as preliminary data from our laboratory suggest that this discrepancy may be due, in part from failure of many studies to clearly differentiate type 1 and type type 2 diabetes in their patient samples. The strongest association between depression and diabetes control has been reported in studies of patients with type 1 diabetes. Research by our group has shown that unlike stress management, behavioral treatment of depression has no impact on diabetes control.
The second major focus of our research program is to evaluate whether the apparent differential relationship between the personality construct of hostility and glucose metabolism in blacks and whites might contribute to the racial disparity in the prevalence of 2 diabetes. African-Americans are at increased risk for developing type 2 diabetes, but the reasons for this racial disparity are poorly understood. We are exploring our previous finding of a differential relationship of hostility to glucose metabolism in African-Americans and Caucasians and determine the underlying behavioral and/or physiologic mechanisms of these relationships. We have shown hostility is related to both impaired pancreatic function as well as increased glucose production in the liver in African American women. Furthermore, the elevated fasting glucose in this group is associated with both increased central adiposity and increased circulating epinephrine. Ongoing studies are seeking to confirm these findings as well as to understand the underlying mechanisms
Finally, our group is looking at novel pharmacologic methods for improving weight loss and impaired glucose metabolism.