***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective : The presence of co-morbid depressive symptoms may have a negative impact on the management of diabetes mellitus . Moreover , some antidepressants may adversely affect glycemic control . Selective serotonin reuptake inhibitors ( SSRIs ) may improve glycemic control and may be beneficial for patients with co-morbid depression and diabetes . We examined the safety and efficacy of s-citalopram therapy in patients with co-morbid depression and diabetes , and its ability to improve glycemic control . Research Design and Methods : 17 patients were enrolled into the trial and 14 patients received open-label s-citalopram therapy for up to 16 weeks . Clinical outcome measures included the 17-item Hamilton depression rating ( HAM-D 17 ) and the clinical global impressions severity ( CGI/S ) and change ( CGI/C ) ratings . In addition , fasting glucose , fructosamine , and glycosylated hemoglobin-A1C measures were obtained before and during s-citalopram therapy . Results : We observed a significant reduction in mean HAM-D 17 ( p < 0.001 ) , CGI/S ( p = 0.001 ) and CGI/C ( p = 0.001 ) ratings during s-citalopram therapy . We also observed a modest , non-significant reduction in fasting glucose , fructosamine , and glycosylated hemoglobin-A1C levels during s-citalopram therapy . Limitation : Limitations of this study include a modest patient sample size and a 16-week treatment duration which may have been insufficient to demonstrate the full effect of SSRI therapy on glycemic control . Conclusion : We observed a significant reduction in depressive symptoms and modest , non-significant reductions in fasting glucose , fructosamine , and glycosylated hemoglobin-A1C levels during SSRI therapy of co-morbid depression and diabetes To evaluate the efficacy and safety of oral magnesium supplementation , with magnesium chloride ( MgCl2 ) , in the treatment of newly diagnosed depression in the elderly with type 2 diabetes and hypomagnesemia . Twenty-three elderly patients with type 2 diabetes and hypomagnesemia were enrolled and r and omly allocated to receive either 50 mL of MgCl2 5 % solution equivalent to 450 mg of elemental magnesium or Imipramine 50 mg daily during 12 weeks . Widowhood or divorce in the last six months , alcoholism , degenerative illnesses of the nervous central system , recent diagnosis of diabetes , previous or current treatment with antidepressants , chronic diarrhea , use of diuretics , and reduced renal function were exclusion criteria . Hypomagnesemia was defined by serum magnesium levels < 1.8 mg/dL and depression by Yasavage and Brink score > or = 11 points . The primary trial end point was the improvement of depression symptoms . At baseline , there were no differences by age ( 69 + /- 5.9 and 66.4 + /- 6.1 years , p = 0.39 ) , duration of diabetes ( 11.8 + /- 7.9 and 8.6 + /- 5.7 years , p = 0.33 ) , serum magnesium levels ( 1.3 + /- 0.04 and 1.4 + /- 0.04 mg/dL , p = 0.09 ) , and Yasavage and Brink Score ( 17.9 + /- 3.9 and 16.1 + /- 4.5 point , p = 0.34 ) in the groups with MgCl2 and imipramine , respectively . At end of follow-up , there were no significant differences in the Yasavage and Brink score ( 11.4 + /- 3.8 and 10.9 + /- 4.3 , p = 0.27 ) between the groups in study ; whereas serum magnesium levels were significantly higher in the group with MgCl2 ( 2.1 + /- 0.08 mg/dL ) than in the subjects with imipramine ( 1.5 + /- 0.07 mg/dL ) , p < 0.0005 . In conclusion , MgCl2 is as effective in the treatment of depressed elderly type 2 diabetics with hypomagnesemia as imipramine 50 mg daily CONTEXT In patients with diabetes mellitus , depression is a prevalent and recurrent problem that adversely affects the medical prognosis . OBJECTIVE To determine whether maintenance therapy with sertraline hydrochloride prevents recurrence of major depression in patients with diabetes . DESIGN A r and omized , double-blind , placebo-controlled , maintenance treatment trial . Patients who recovered from depression during open-label sertraline treatment continued to receive sertraline ( n = 79 ) or  placebo ( n = 73 ) and were followed up for up to 52 weeks or until depression recurred . SETTING Outpatient clinics at Washington University , St Louis , MO , the University of Washington , Seattle , and the University of Arizona , Tucson . PATIENTS One hundred fifty-two patients with diabetes ( mean age , 52.8 years ; 59.9 % female ; 82.9 % with type 2 diabetes ) who recovered from major depression ( 43.3 % of those initially assigned ) during 16 weeks of open-label treatment with sertraline ( mean dose , 117.9 mg/d ) . INTERVENTION Sertraline continued at recovery dose or identical-appearing placebo . MAIN OUTCOME MEASURES The primary outcome was length of time ( measured as the number of days after r and omization ) to recurrence of major depression as defined in DSM-IV . The secondary outcome was glycemic control , which was assessed via serial determinations of glycosylated hemoglobin levels . RESULTS Sertraline conferred significantly greater prophylaxis against depression recurrence than did placebo ( hazard ratio = 0.51 ; 95 % confidence interval , 0.31 - 0.85 ; P = .02 ) . Elapsed time before major depression recurred in one third of the patients increased from 57 days in patients who received placebo to 226 days in patients treated with sertraline .  Glycosylated hemoglobin levels decreased during the open treatment phase ( mean + /- SD glycosylated hemoglobin level reduction , -0.4 % + /- 1.4 % ; P = .002 ) . Glycosylated hemoglobin levels remained significantly lower than baseline during depression-free maintenance ( P = .002 ) and did not differ between treatment groups ( P = .90 ) . CONCLUSIONS In patients with diabetes , maintenance therapy with sertraline prolongs the depression-free interval following recovery from major depression . Depression recovery with sertraline as well as sustained remission with or without treatment are associated with improvements in glycosylated hemoglobin levels for at least 1 year BACKGROUND This study aims to investigate the efficacy of fluoxetine and paroxetine on the levels of depression-anxiety , quality of life , disability , and metabolic control in type II diabetes mellitus ( DM ) patients . METHODS The patients were first applied the Hospital Anxiety-Depression Scale ( HADS ) . After a psychiatric interview with patients who had scores above the cut-off point , those who were diagnosed as having a major depressive disorder according to DSM-IV criteria were applied the Hamilton Depression Rating Scale ( HDRS ) and the Hamilton Anxiety Rating Scale ( HARS ) .  Twenty three patients who scored 16 or above on the HDRS were included in the study and given the Short Form-36 ( SF-36 ) , and the Brief Disability Question naire ( BDQ ) and HbA1c levels were measured . Patients were r and omized on 20 mg/day fluoxetine or 20 mg/day paroxetine treatment . The patients were evaluated with the same scales at the 2(nd ) , 4(th ) , 6(th ) , and the 12(th ) weeks . RESULTS Both groups showed a statistically significant decrease in HDRS , HARS , and BDQ scores with comparison to the index assessment . At the end of treatment , though not statistically significant , a decrease was observed in HbA1c values of the fluoxetine-administered group . CONCLUSIONS Fluoxetine and paroxetine effectively reduce the severity of major depressive disorder in type II DM patients . There is need for further and longer-lasting monitoring studies with more patients in order to determine whether there is any difference in terms of their effects on glycemic control OBJECTIVE To determine whether pharmacological treatment of depression in low-income minorities with diabetes improves A1C and quality of life ( QOL ) . RESEARCH DESIGN AND METHODS This was a 6-month , r and omized , double-blind , placebo-controlled trial . Patients were screened for depression using Whooley 's two- question tool at a county diabetes clinic . Depression was confirmed ( or not ) with the Computerized Diagnostic Interview Survey ( CDIS ) software program , and the severity of depression was assessed monthly by the Hamilton Depression Scale ( HAM-D ) . Depressed subjects with A1C levels ≥8.0 % were r and omly assigned to receive either sertraline or placebo . Diabetes care was provided by nurses following detailed treatment algorithms who were unaware of therapy for depression . RESULTS A total of 150 subjects answered positively to at least one question on Whooley 's question naire . The positive predictive value for depression diagnosed by CDIS was 69 , 67 , and 84 % for positive answers to question 1 only , question 2 only , or both , respectively . Of the 89 subjects who entered the study , 75 completed . An intention-to-treat analysis revealed significant differences between baseline and 6 months in HAM-D and pain scores , QOL , and A1C and systolic blood pressure levels in both groups , with no differences between groups for the first three but a significantly greater decrease with sertraline in A1C and systolic blood pressure levels . Changes in HAM-D scores and A1C levels were significantly correlated in all subjects ( P = 0.45 [ P < 10−6 ] ) . CONCLUSIONS In this low-income minority population  , pharmacological treatment  of depression significantly improved A1C and systolic blood pressure levels  compared with placebo OBJECTIVE Depression is prevalent in patients with diabetes . It is associated with poor glycemic control and is linked to an increased risk for diabetic complications . In this study , we assessed the efficacy of fluoxetine for depression in patients with diabetes . RESEARCH DESIGN AND METHODS Sixty patients with diabetes ( type 1 , n = 26 ; type 2 , n = 34 ) and major depressive disorder entered an 8-week r and omized placebo-controlled double-blind trial . Patients were given daily doses of fluoxetine ( up to 40 mg/day ) . The Beck Depression Inventory ( BDI ) and Hamilton Rating Scale for Depression ( HAMD ) were used to measure the severity of depression and to determine the percentage of patients who achieved substantial improvement or complete remission . GHb levels were obtained to monitor glycemic control . RESULTS Reduction in depression symptoms was significantly greater in patients treated with fluoxetine compared with those receiving placebo ( BDI , -14.0 vs. -8.8 , P = 0.03 ; HAMD , -10.7 vs. -5.2 , P = 0.01 ) . The percentage of patients achieving a significant improvement in depression per the BDI was also higher in the fluoxetine group ( 66.7 vs. 37.0 % , P = 0.03 ) . Additionally , trends toward a greater rate of depression remission ( 48.1 vs. 25.9 % , P = 0.09 per the HAMD ) and greater reduction in GHb ( -0.40 vs. -0.07 % , P = 0.13 ) were observed in the fluoxetine group . CONCLUSIONS Fluoxetine effectively reduces the severity of depression in diabetic patients . Our study demonstrated that after only 8 weeks , this treatment also produced a trend toward better glycemic control OBJECTIVES Depression is prevalent in patients with type 2 diabetes and affects quality of life . The prevalence of depression in the sample of Croatian patients with diabetes is 32.2 % . The main aim of the investigation was to evaluate the effect of antidepressant treatment on quality of life and metabolic control in depressed diabetic patients . DESIGN AND METHODS In the sample we r and omized 60 diabetic out patients with optimally controlled diabetes and with depression . The efficacy of 50 mg sertraline per day treatment was tested by the MADRAS question naire in a 24-week period , where the patients controlled themselves . Changes in the quality of life as the consequences of treatment of depression were tested by the QLSQ question naire for the quality of life follow-up . RESULTS The MADRAS scale results , measuring the changes in the degree of depression , showed substantial improvement of condition throughout the whole treatment . The first eight weeks of treatment presented statistically high significance in examinees in all the groups of chronic somatic diseases . The QLSQ scale results for measuring the quality of life showed marked improvement . Statistically significant changes occurred during the first eight weeks of treatment . Two patients withdrew their consent before starting medication and 13 dropped out later in the study . Treatment of depression with sertraline in chronic som 
    Output:
    
In total , we ended up with 18 articles for our purpose s. RESULTS The combination of depression and DM may be harmful as depression has a strong impact on psychosocial and medical outcomes in patients with DM .
It showed that depression improvement had a favourable effect on glycaemic control that was weight independent .
Bear in mind that there is a possible risk of hypoglycemia when using SSRIs .