Type 1 Diabetes and Depression: Role of Brain Glutamate

This is an interventional basic science trial for Type1diabetes focused on measuring Hyperglycemia, Euglycemic hyperinsulinemic clamp, Euglycemia, Magnetic Resonance Spectroscopy, Magnetic Resonance Imaging, Glutamate Read More

T1DM Subjects:

Inclusion Criteria:

• 10-25 years duration of T1DM.
• Relatively low levels of complications from diabetes.

Exclusion Criteria:

• Type 2 diabetes and/or gestational diabetes.
• Other major clinical conditions such as cancer, symptomatic coronary artery disease, (e.g., prior myocardial infarction), stroke, proliferative diabetic retinopathy requiring a laser treatment, clinically significant diabetic nephropathy as evidenced by urinary albumin levels > 300 mg/day and/or serum creatinine > 1.5 mg/dl for men and > 1.4 mg/dl for women, painful or symptomatic neuropathy, and/or diagnosed gastroparesis.
• Current or past history of attention deficit hyperactivity disorder, bipolar disorder, obsessive compulsive disorder, panic disorder, substance dependence or schizophrenia.
• Ethanol dependence and/or nicotine dependence according to Diagnostic and Statistical Manual-IV criteria and heavy smokers according to the Epidemiology of Diabetes Interventions and Complications scale 57.

Control Subjects:

Inclusion Criteria:

• No history of T1DM or Major Depressive Disorder.
• Normal fasting blood glucose, HbA1c and hematocrit levels.

Exclusion Criteria:

• Known chronic medical illness such as rheumatoid arthritis or major cardiac, kidney or liver disease or anemia.
• Current or past history of attention deficit hyperactivity disorder, bipolar disorder, obsessive compulsive disorder, panic disorder, substance dependence or schizophrenia.
• Past history of a major depressive episode, as well as with current symptoms of depression as defined by a HAMD-17 score ≥ 10.

Subjects with depressive history and current depressive symptoms:

Inclusion criteria:

• History of at least one episode of major depression.
• A 17-item HAM-D (HAMD-17) score ≥ 10 and ≤ 27

Exclusion criteria:

• Current or past history of attention deficit hyperactivity disorder, bipolar disorder, obsessive compulsive disorder, panic disorder, substance dependence or schizophrenia.
• Subjects under current treatment with antidepressant medication.
• Subjects with acute severe depression or acute suicidal ideation, who in the opinion of the psychiatrist are clinically inappropriate for participation in the study.
• Subjects who in the opinion of the psychiatrist are clinically inappropriate for a one-week delay in antidepressant medication treatment.
• HAMD-17 score > 27.

All Subjects:

Exclusion criteria related to MR procedure:

Participants who have metal in their body, suffer from claustrophobia or panic disorder or women who are pregnant, or who are currently breast-feeding cannot participate in this research study.

Additional MR exclusion criteria include people with:

• Cardiac pacemakers
• Metal clips on blood vessels (also called stents)
• Artificial heart valves
• Artificial arms, hands, legs, etc.
• Brain stimulator devices
• Implanted drug pumps
• Ear implants
• Eye implants or known metal fragments in eyes
• Exposure to shrapnel or metal filings (wounded in military combat, sheet metal workers, welders, and others)
• Other metallic surgical hardware in vital areas
• Certain tattoos with metallic ink (subjects are requested to inform the investigator if they have a tattoo)
• Certain transdermal (skin) patches such as NicoDerm (nicotine for tobacco dependence), Transderm Scop (scopolamine for motion sickness), or Ortho Evra (birth control).
• Claustrophobia