The Effects of Depression on Diabetes Knowledge, Diabetes Self-Management, and Perceived Control in Indigent Patients with Type 2 Diabetes

BACKGROUND: This study was designed to assess differences in diabetes knowledge, diabetes self-management, and perceived control among depressed and nondepressed individuals in an indigent population with type 2 diabetes. RESEARCH DESIGN AND METHODS: Depressed and nondepressed patients with the clinical diagnosis of type 2 diabetes were recruited from an indigent care clinic. Subjects completed validated surveys to assess diabetes knowledge, diabetes self-management, and perceived control of diabetes. We compared demographic characteristics and diabetes knowledge, diabetes self-management, and perceived control of diabetes by depression status. Statistical analysis was performed with SPSS version 14.0 (SPSS, Inc., Chicago, IL). RESULTS: Of the 201 subjects with diagnosed type 2 diabetes enrolled in the study, approximately 20% n = 40) of the sample was depressed. Subjects with depression were more likely to report self-care control problems (mean = 2.2 +/- 1.0 vs. 1.5 +/- 0.6, P < 0.001) and less likely to report positive attitude (mean = 2.9 +/- 0.7 vs. 3.7 +/- 0.5, P < 0.001), self-care ability (mean = 3.2 +/- 3.6 vs. 3.7 +/- 0.5, P < 0.001), and self-care adherence (mean = 3.3 +/- 0.9 vs. 4.1 +/- 0.6, P < 0.001). Depressed patients were less likely to report perceived control of diabetes (mean = 47.7 +/- 8.5 vs. 57.8 +/- 7.4, P < 0.001). There were no significant differences in diabetes knowledge, self-care understanding, and perceived importance of self-care between depressed and nondepressed patients. CONCLUSIONS: In this indigent population with type 2 diabetes, diabetes knowledge did not differ significantly by depression status, but diabetes self-management practices and perceived control of diabetes differed significantly by depression status. Patients who were depressed had poorer diabetes self-care and felt they had less control over their disease.