Depressive symptoms were associated with lower self-management in both T1DM (coefficient -0.34, p<0.001) and T2DM (coefficient -0.41, p<0.001), indirectly leading to higher HbA1c.
Cross-Sectional (n=606)
Are depression and diabetes distress associated with self-management behavior and glycemic control in patients with Type 1 and Type 2 diabetes?
Depression is linked to less optimal diabetes self-management and indirectly to worse glycemic control in both T1DM and T2DM, while diabetes distress is additionally associated with higher HbA1c.
Effect estimate: Standardized coefficient -0.34 (T1DM) and -0.41 (T2DM) for depression on self-management
p-value: p=<.001
OBJECTIVE: To analyze the independent associations of depression and diabetes distress with self-management and glycemic outcome in Type I (T1DM) and Type 2 diabetes (T2DM). METHOD: Six hundred six people with T1DM or T2DM participated in a cross-sectional survey including measures of depression (PHQ-9), diabetes distress (PAID-5), self-management behavior (DSMQ), and glycemic outcome (HbA1c). Structural equation modeling was performed to analyze the independent linear associations (standardized coefficients) between these variables. RESULTS: In those with T1DM (n = 339), both depressive symptoms and diabetes distress were associated with lower self-management (-0.34, p < .001, and -0.16, p = .007, respectively) and thereover (indirectly) with higher HbA1c (0.20, p < .001, and 0.10, p = .016, respectively); direct associations with HbA1c were not observed. In those with T2DM (n = 267), only depressive symptoms were associated with lower self-management (-0.41, p < .001) and thus (indirectly) with higher HbA1c (0.17, p < .001). Diabetes distress, by contrast, was directly associated with higher HbA1c (0.20, p = .003) but not with self-management. CONCLUSIONS: The results are consistent with the hypothesis that depression is linked to less optimal diabetes self-management, thus leading to less optimal glycemic outcome. The associations were relatively consistent across diabetes types. Diabetes distress was additionally associated with higher glycemic levels, suggesting that people with both depression and diabetes distress might have the least optimal outcome. The conclusions are limited by the cross-sectional study design, self-report assessment of behavior, and potential bias arising from questionnaire measures. Further research is needed to support these findings. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Schmitt et al. (Mon,) conducted a cross-sectional in Type 1 and Type 2 diabetes (n=606). Depression and diabetes distress was evaluated on Self-management behavior and glycemic outcome (HbA1c) (Standardized coefficient -0.34 (T1DM) and -0.41 (T2DM) for depression on self-management, p=<.001). Depressive symptoms were associated with lower self-management in both T1DM (coefficient -0.34, p<0.001) and T2DM (coefficient -0.41, p<0.001), indirectly leading to higher HbA1c.