Research Communications

Fighting Depression 

Exercise, talk therapy program treats people with diabetes

Dec. 15, 2009

People with diabetes are twice as likely to experience depression, and those in Appalachia may not have access to resources for treatment. But researchers now have found that depression in people with type 2 diabetes can be combated with a combination of exercise and talk therapy, components of an Ohio University initiative called Program ACTIVE (Appalachians Coming Together to Increase Vital Exercise).

“This group can be one of the hardest to treat, but we saw significant improvements in depression and glucose control,” says Jay Shubrook, an associate professor of family medicine at Ohio University’s College of Osteopathic Medicine who specializes in diabetes treatment. He and colleagues Frank Schwartz and Michael Kushnick collaborated on the study led by Mary de Groot, an associate professor at the Indiana University School of Medicine who launched the program while at Ohio University.


With funding from the National Institutes of Health, the team created Program ACTIVE as a pilot treatment study. The project recruited 50 volun- teers with an average age of 57. The volunteers completed 150 minutes of exercise at local community centers for 12 weeks and participated in 10 weeks of counseling. The researchers created walking maps of the community, and participants logged and reported their daily exercise back to the researchers. Participants collectively walked 8,885 miles during the program, which is the equivalent of four round trips on the Appalachian Trail.

All that walking and talking turned out to be highly beneficial. Two- thirds of participants showed remission rates of depression immediately after the study, as well as three months later. Participants also experienced significant decreases in blood sugar and fasting glucose, as well as major gains in cardiovascular health during a stress test on an exercise bike. Volunteers also reported higher levels of social and emotional well-being and increased support from family and healthcare providers.

“Combined intervention is better than approaching one problem or the other alone,” says Schwartz, J.O. Watson Endowed Diabetes Research Chair and professor of endocrinology in Ohio University’s College of Osteopathic Medicine. “Early intervention with exercise for either diabetes or depression would not only help that condition, but might reduce the risk of developing the other associated condition.”

Because the treatment doesn’t require medication, it’s also potentially more cost-effective, Shubrook adds.

The team plans to expand Program ACTIVE to four to five additional sites in Appalachia—where the overall incidence of diabetes is higher than the national average, the Ohio University researchers have found—and other rural areas in the Midwest. It may be especially useful in medically underserved areas, de Groot says.

“We have too few psychologists, social workers, and psychiatrists in the Appalachian region, but we know that depression is out there,” she says. “This study was designed to begin to create tools that could be used for a larger scale program for treatment.”

By Jaclyn Lipp

This article will appear in the Autumn/Winter 2009 issue of Perspectives magazine. 

For more information about program ACTIVE at Ohio University, visit: