title: Depression and glycemic control in Hispanic primary care patients with diabetes.
abstract: BACKGROUND
  Maintaining optimal glycemic control is an important goal of therapy in patients with diabetes mellitus. Patients of Hispanic ancestry have been shown to have high rates of diabetes and poor glycemic control (PGC). Although depression is common in adults with diabetes, its relationship to glycemic control remains unclear, especially among Hispanics.
  
  
  OBJECTIVE
  To assess the association of depression with PGC in Hispanics.
  
  
  METHODS
  Data from a cross-sectional mental health survey in primary care were crosslinked to the hospital's computerized laboratory database.
  
  
  METHODS
  Urban general medicine practice at a teaching hospital.
  
  
  METHODS
  Two hundred and nine patients (mean [standard deviation] age, 57.1 [10.3] years; 68% females) with recent International Classification of Diseases, Ninth Revision (ICD-9) codes for diabetes mellitus, and 1 or more hemoglobin A(1c) (HbA(1c)) tests.
  
  
  METHODS
  Probability of PGC (HbA(1c)>or=8%).
  
  
  RESULTS
  Probability for PGC steadily increased with severity of depression. Thirty-nine (55.7%) of the 70 patients with major depression had HbA(1c)>or=8%, compared with 39/92 (42.4%) in the minimal to mild depression group, and 15/47 (31.9%) in the no depression group (P(trend)=.01; adjusted odds ratio, 3.27; 95% confidence interval, 1.23 to 8.64, for moderate or severe depression vs no depression). Only 29 (41.4%) of the patients with major depression received mental health treatment in the previous year.
  
  
  CONCLUSIONS
  In this primary care sample of Hispanic patients with diabetes, we found a significant association between increasing depression severity and PGC. Yet, less than one half of the patients with moderate or severe depression received mental health treatment in the previous year. Improving identification and treatment of depression in this high-risk population might have favorable effects on diabetic outcomes.
authors.affiliation: Division of Clinical and Genetic Epidemiology, New York State Psychiatric Institute, New York, NY, USA. rg547@columbia.edu <rg547@columbia.edu>
authors.forename: Raz
authors.initials: R
authors.lastname: Gross
authors.forename: Mark
authors.initials: M
authors.lastname: Olfson
authors.forename: Marc J
authors.initials: MJ
authors.lastname: Gameroff
authors.forename: Olveen
authors.initials: O
authors.lastname: Carasquillo
authors.forename: Steven
authors.initials: S
authors.lastname: Shea
authors.forename: Adriana
authors.initials: A
authors.lastname: Feder
authors.forename: Rafael
authors.initials: R
authors.lastname: Lantigua
authors.forename: Milton
authors.initials: M
authors.lastname: Fuentes
authors.forename: Myrna M
authors.initials: MM
authors.lastname: Weissman
mesh_terms: D000368:Aged; D015897:Comorbidity; D015986:Confounding Factors, Epidemiologic; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology / Q000208:ethnology*; D005260:Female; D006442:Glycated Hemoglobin; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology
chemical_list: D006442:Glycated Hemoglobin