Association between symptoms of depression and glycaemic control may be unstable across gender.
OBJECTIVE
Lloyd and colleagues (Diabetic Med 2000; 17, 198-202) have described an association between poor glycaemic control and moderate to severe depression in male but not in female diabetes patients. However, the validity of this study may be limited by its small sample size and the influence of uncontrolled confounders. Therefore, we set out to replicate this study by investigating the associations between depression and glycaemic control in larger samples, while controlling for potential confounders.


METHODS
Out-patients with diabetes (n = 174) and 1437 patient members of the Dutch Diabetes Association (DDA) completed the Hospital Anxiety and Depression Scale. Demographic and clinical characteristics were obtained using medical records (out-patients) or self-report (DDA).


RESULTS
After controlling for number of complications, years of education and body mass index, depression showed significant, low positive correlations with HbA(1c) in three of the four female samples and in one of the four male samples. Only for out-patients with Type 2 diabetes was the correlation between HbA(1c) and depression significantly higher for women when compared with men (0.19 vs. 0.04; P = 0.02).


CONCLUSIONS
The association between depression and HbA1c may be stronger in women with Type 2 diabetes. Oestrogen levels and self-care behaviours may play a mediating role in this association. Further research is required before we can conclude that the association between symptoms of depression and glycaemic control differs across gender. Diabet. Med. 18, 595-598 (2001)
Pouwer
F
F
Department of Medical Psychology, Research Institute for Endocrinology, Reproduction and Metabolism, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands. f.pouwer.emgo@med.vu.nl
Snoek
F J
FJ
D000328:Adult; D001007:Anxiety / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D003863:Depression / Q000097:blood*; D003866:Depressive Disorder / Q000097:blood*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000523:psychology*; D004522:Educational Status; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012727:Sex Characteristics
D001786:Blood Glucose; D006442:Glycated Hemoglobin