Efficacy of a Web-Based Intervention With Mobile Phone Support in Treating Depressive Symptoms in Adults With Type 1 and Type 2 Diabetes: A Randomized Controlled Trial DOI: 10.2337/dc14-1728 OBJECTIVE Depression is common in diabetes and linked to adverse health outcomes. This study evaluated the efficacy of a guided web-based intervention in reducing de- pression in adults with type 1 and type 2 diabetes. RESEARCH DESIGN AND METHODS A total of 260 participants with diabetes and elevated depressive symptoms (Center for Epidemiological Studies Depression Scale [CES-D ‡23]) were randomly assigned to the GET.ON Mood Enhancer Diabetes (a guided self-help intervention, n = 130) or a brief online unguided psychoeducation program for depression (n = 130). The primary outcome was depressive symptoms severity (CES-D). The sec- ondary outcomes included diabetes-specific emotional distress (Problem Areas in Diabetes [PAID] scale) and participant satisfaction (adaption CSQ-8). Data were collected at baseline and 2 months after randomization. To identify differences in outcome between the groups, we used analyses of covariance with the baseline CES-D score as covariate on both intent-to-treat (ITT) and per-protocol (PP) basis. RESULTS Compared with the control group, the intervention group showed significantly less depressive symptom severity at posttreatment based on ITT (d = 0.89) and PP analyses (d = 1.00). The intervention participants displayed a significantly larger reduction in diabetes-specific emotional distress (d = 0.58, ITT). The intervention appeared to be acceptable to the participants; 95% (n = 121) would recommend the training to a friend with diabetes in need of psychological help. CONCLUSIONS A guided, web-based intervention to reduce depression in adults with type 1 and type 2 diabetes is effective in reducing both depressive symptoms and diabetes- specific emotional distress. 1 Division of Online Health Training, Innovation Incubator, Leuphana University Lueneburg, Germany 2 Department for Health Care Policy, Harvard University, Boston, MA 3 Department of Clinical Psychology and Psy- chotherapy, Friedrich-Alexander-University Erlangen-Nuremberg Erlangen, Germany 4 Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology Albert- Ludwigs-University Freiburg, Freiburg, Germany 5 Institute for Health and Care Research (EMGO), VU University Medical Centre, Amsterdam, the Netherlands 6 Department of Medical Psychology, VU Uni- versity Medical Centre and Academic Medical Center and Academic Medical Center, Amster- dam, the Netherlands 7 Department of Clinical Psychology, VU Univer- sity, Amsterdam, the Netherlands 8 Institute of Telepsychiatry, University of South- ern Denmark, Odense, Denmark Corresponding author: Stephanie Nobis, nobis@ inkubator.leuphana.de. Received 17 July 2014 and accepted 31 January 2015. Clinical trial reg. no. DRKS00004748, German Clinical Trial Register, https://drks-neu.uniklinik- freiburg.de/drks_web/ © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. Stephanie Nobis, 1 Dirk Lehr, 1 David Daniel Ebert, 1,2,3 Harald Baumeister, 4 Frank Snoek, 5,6 Heleen Riper, 1,5,7,8 and Matthias Berking 1,3 Diabetes Care 1 CLIN CARE/EDUCATION/NUTRITION/PSYCHOSOCIAL Diabetes Care Publish Ahead of Print, published online February 20, 2015