Learning Objective #1: explain the relationship between depression and outcomes in diabetics. | |||
Learning Objective #2: to explain that the interrelationship of depression, diabetes control, and co morbidities has been established in type 1 but not type 2 diabetics. |
Objective: This study was conducted to examine whether diabetes-related complications, depression, or quality of life predict diabetes control beyond the contributions of demographic characteristics in type 2 diabetes?
Design: Cross sectional survey
Population, Sample, Setting: Type 2 diabetics (N=55) aged ³35 years, 42% female, 36% African American were recruited by convenience sample from an inner city Joslin diabetes clinic.
Variables: Dependent: HbA1c; Independent: demographics, depression, quality of life (QOL), diabetes-related macro (coronary artery disease, hyperlipidemia, hypertension, obesity) and micro (nephropathy, neuropathy, retinopathy) co-morbidities
Methods: After informed consent patients completed Beck Depression Inventory-II (BDI, depression), SF-36 (QOL), demographic questionnaire. Complications, HbA1c, height and weight were obtained from the medical record.
Findings: HbA1c: 40% well controlled (≤7%), 44% moderate-high (7-9%), and 16% very high (³ 9%). All patients had at least 1 diabetes-related co-morbidity; 58% had ³ 1 micro co-morbidities; 64% had 2 -3 macro co-morbidities; 41% were depressed (BDI ³13); 27% moderately or severely depressed (BDI ³20). Being black tended to predict higher HbA1c [F(1,51)=3.321, p=.074, R2=.06]. Neither gender nor age added significantly to prediction of HbA1c. Neuropathy [F(1,50)=.979, p=.007, R2=.158] and retinopathy [F(1,50) =3.610, p=.063, R2=.089] added to the prediction beyond race, other co-morbidities didn’t. Depression tended to add to prediction of HbA1c [F(1,50)=3.728, p=.059, R2=.091]; QOL did not.
Conclusion: Longitudinal research is necessary to clarify the inter-relationship of depression, quality of life, self-care behaviors, and diabetes control in type 2 diabetics.