title: Depression and poor glycemic control: a meta-analytic review of the literature.
abstract: OBJECTIVE
  Depression is common among patients with diabetes, but its relationship to glycemic control has not been systematically reviewed. Our objective was to determine whether depression is associated with poor glycemic control.
  
  
  METHODS
  Medline and PsycINFO databases and published reference lists were used to identify studies that measured the association of depression with glycemic control. Meta-analytic procedures were used to convert the findings to a common metric, calculate effect sizes (ESs), and statistically analyze the collective data.
  
  
  RESULTS
  A total of 24 studies satisfied the inclusion and exclusion criteria for the meta-analysis. Depression was significantly associated with hyperglycemia (Z = 5.4, P < 0.0001). The standardized ES was in the small-to-moderate range (0.17) and was consistent, as the 95% CI was narrow (0.13-0.21). The ES was similar in studies of either type 1 or type 2 diabetes (ES 0.19 vs. 0.16) and larger when standardized interviews and diagnostic criteria rather than self-report questionnaires were used to assess depression (ES 0.28 vs. 0.15).
  
  
  CONCLUSIONS
  Depression is associated with hyperglycemia in patients with type 1 or type 2 diabetes. Additional studies are needed to establish the directional nature of this relationship and to determine the effects of depression treatment on glycemic control and the long-term course of diabetes.
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, and the Department of Veterans Affairs Medical Center, St Louis, Missouri, USA. lustmanp@psychiatry.wustl.edu
authors.forename: P J
authors.initials: PJ
authors.lastname: Lustman
authors.forename: R J
authors.initials: RJ
authors.lastname: Anderson
authors.forename: K E
authors.initials: KE
authors.lastname: Freedland
authors.forename: M
authors.initials: M
authors.lastname: de Groot
authors.forename: R M
authors.initials: RM
authors.lastname: Carney
authors.forename: R E
authors.initials: RE
authors.lastname: Clouse
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D016208:Databases, Factual; D003863:Depression; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000523:psychology*; D006801:Humans; D016239:MEDLINE
chemical_list: D001786:Blood Glucose