Type 1 Diabetes and Depression: Role of Brain Glutamate

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:
• •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:
• •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:
• •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.
• •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