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Alan M. Jacobson, M.D.

Dr. Jacobson is the Senior Vice President at Joslin. He directs Joslin’s Behavioral Research Program and heads the Joslin Clinic Section on Behavioral and Mental Health. He is also a Professor of Psychiatry at Harvard Medical School and has authored more than150 articles, chapters and books. The recipient of numerous awards and honors—including election to the Academy of Behavioral Medicine Research—Dr. Jacobson is a Distinguished Fellow of the American Psychiatric Association. He has served as a scientific consultant to the National Institutes of Health (NIH) and been the Principal Investigator on several large NIH-sponsored research studies on the psychological aspects of diabetes. He received his medical degree from the University of Chicago Medical School and completed his residency in Psychiatry at Massachusetts General Hospital in Boston.

For the past 25 years, Dr.Jacobson has investigated issues that lie at the interface between diabetes and psychology: the influence of diabetes on brain structure and functioning, the quality of life and personal growth of patients and their families, and the impact of psychological and social factors on diabetes outcomes.

To address these important issues, Dr. Jacobson co-developed two measurement systems—the Diabetes Quality of Life Measure and the Problem Areas in Diabetes Scale—which have been translated into several languages and are now widely used around the world.

In recent years, Dr. Jacobson, who leads the Section on Behavioral and Mental Health, and his colleagues at Joslin have turned their attention to the impact of diabetes on the development of depression and related disorders.They also are examining whether depressive disorders previously thought to be socially or emotionally driven may, in fact, have biological causes elicited by diabetic metabolism. Specifically, they are studying whether the metabolic changes of diabetes cause structural and functional changes in the central nervous system (CNS), which may then lead to an increased risk of depressive disorders.

One hypothesis is that fluctuations in blood glucose levels—both hyperglycemia and hypoglycemia—affect the integrity of the CNS in the areas of the brain that control emotion. For example, some of the problems associated with hypoglycemia (low blood glucose) are lack of awareness and inability to reason. In a pilot studyDr. Jacobson is “mapping” the CNS to determine which parts of the brain control hypoglycemia and the patient’s awareness of it. This study will provide a scientific baseline for further research and may help identify potential targets for pharmacological interventions.

The Joslin team is one of the few diabetes research groups in the world to focus so intensively on the relationship between depression and diabetes. Dr. Jacobson’s work will lead to a deeper understanding of the influence of diabetes on the CNS and of the CNS on diabetes. For example, diabetes-induced changes in brain or hormone function may lead to additional changes related to appetite controls. Further, the effects of diabetes-induced depression may in turn compromise a patient’s ability to adhere to diabetes control regimens. Identification of specific CNS or hormonal changes related to diabetes also may expand the list of early markers for diabetes risk. This research will have implications not only for people with diabetes, but potentially for others whose depression may be biological.

Selected References
Musen G, Lyoo IK, Sparks CR, Weinger K, Hwang J, Ryan CM, Jimerson DC, Hennen J, Renshaw PF, Jacobson AM. Effects of type 1 diabetes on gray matter density as measured by voxel-based morphometry. Diabetes 55:326-333, 2006.

Goebel-Fabbri AE, Musen G, Sparks CR, Greene JA, Levenson, JL, Jacobson AM. Endocrine and metabolic disorders. Textbook of Psychosomatic Medicine. Levenson JL (ed). Washington, DC: American Psychiatric Publishing, pp. 495-515, 2005.

Jacobson AM, Samson JA, Weinger K, Ryan CM. Diabetes, the brain and behavior: Is there a biological mechanism underlying the association between diabetes and depression? Int Rev Neurobiol 51:455-479, 2002.

Jacobson AM. The psychological care of patients with insulin-dependent diabetes mellitus. N Engl J Med 334:1249-1253, 1996.

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Page last updated: April 19, 2014