Diabetes Risk Reduction Through Eat, Walk, Sleep and Medication Therapy Management for Depressed Cambodians

Cambodian Americans have high risk for major depressive disorder and for type 2 diabetes.
Depression is a known risk factor for diabetes. Some antidepressants can also increase risk
of depression by causing weight gain. DREAM will test the effect of lifestyle and medication
therapy management (MTM) on diabetes risk among depressed Cambodian Americans. Community
health workers (CHWs) will deliver the lifestyle intervention and assist pharmacists with
MTM. Lifestyle and biological risk factors for diabetes, such as depressive symptoms and
insulin sensitivity, will be measured before and after the interventions.

Inclusion Criteria:

- Self-identified as Cambodian or Cambodian-American

- Khmer speaking

- Major depressive disorder

- Elevated diabetes risk score per ADA guidelines

- >= 3 medications

- Ambulatory

- Competent to give consent.

Exclusion Criteria:

- Pregnancy or plans to become pregnant in the next 2 years

- Previous diagnosis of diabetes

- Vision or hearing problems that would prevent participation in group sessions

- Currently being followed by a physician for major medical problem

- Currently being followed by a healthcare provider for major psychiatric problem other
than depression