A patient with depression and diabetes or heart disease or three conditions combined would be better off having a nurse to help coordinate all the care or treatments, a new trial suggests.

Other Studies suggest following a vegetarian diet and taking vitamin D may also help people with depression, heart disease and or diabetes mellitus.

Many people in the United States suffer multiple chronic diseases likely diabetes mellitus and heart disease.  When these patients also suffer depression, the treatments often do not result in good outcomes.

The randomized controlled trial found patients who received care from nurses who worked with patients and physicians to manage the care for depression and physical diseases fared better than those who received only care from individual physicians.

University of Washington researchers reported their findings in the Dec 30, 2010 issue of New England Journal of Medicine.

Dr. Wayne J. Katon and colleagues studied 224 patients assigned either standard care or the TeamCare intervention in which, a nurse worked with each patient, helped monitor disease control like cholesterol, blood pressure, blood sugar, and depression and worked closely with each patient's primary physicians to help patients use medications properly and effectively. Nurses are in high demand due to their success with patients and there are a number of Los Angeles hospital jobs as well as other large city nursing jobs available.

The researchers found at one year of the trial, those receiving the TEAMcare were less depressed and had their blood sugar, cholesterol and blood pressure better controlled, compared with other patients with depression, diabetes mellitus and heart disease.

The cost for the two-year Teamcare intervention was $1,224 per patient, which may not be too much considering that their medical care cost was as high as $10,000 per year per patient.

The patients who received the Teamcare intervention were reportedly more likely to be satisfied with the quality of life and treatments for depression and either diabetes mellitus, heart disease or both. These patients more likely had timely adjustments for blood sugar levels, high blood pressure, cholesterol and medications.

Patients may also find it helpful to maintain an adequate serum vitamin D level and to use a vegetarian diet, previous studies have suggested.

Vitamin D deficiency has been linked with elevated risk of diabetes mellitus, heart disease and depression.

W.J. Craig of Andrews University in Berrien Springs, MI said in the Dec 2010 issue of Nutrition in Clinical Practice that a vegetarian diet full of fruit, vegetables, whole-grains, legumes, nuts and various soy products provides low saturated fat and cholesterol and high amounts of dietary fiber and health-promoting phytochemicals.

Craig said people who followed a vegetarian diet typically have normal healthy body weight, a healthy cholesterol profile, normal blood pressure, reduced risk of ischemic heart disease, hypertension, stroke, type 2 diabetes mellitus and certain cancer, compared with non-vegetarians.

L. Mascitelli and colleagues from Servizio Sanitario in Italy reported in May 2010 in Recent Progress in Medicine that vitamin D insufficiency seems to predispose individuals to hypertension, diabetes mellitus, metabolic syndrome, left ventricular hypertrophy, heart failure, and chronic vascular inflammation.

Mascitelli et al. said increasing evidence suggests people with vitamin D insufficiency can reduce the morbidity and mortality of cardiovascular disease by taking vitamin D supplements.

David Liu