Treatment regimen determines the relationship between depression and glycemic control.
Several recent studies have suggested that depression is related to poorer glycemic control in patients with type 1 diabetes, but not in type 2 diabetes. We hypothesize that complexity of self-care regimen rather than the type of diabetes, is more important in determining this relationship of depression to glycemic control.


METHODS
One thousand thirty-four adults with diabetes were recruited for the study. These patients were treated with: diet and exercise, oral medications, oral medications and insulin, 1-2 daily injections of insulin, and > or =3 daily injections. All participants completed the Beck depression inventory (BDI) and had a hemoglobin A(1c) (HbA(1c)) performed as part of routine clinical care.


RESULTS
Pearson correlations between BDI scores and HbA(1c) were low and insignificant in all groups (0.015< or =r< or =0.066) except for those administering three or more daily shots of insulin (r=0.284; p=0.034).


CONCLUSIONS
The results of this study clearly show that while depressive symptoms are significantly correlated to glycemic control in patients taking three or more insulin injections per day, there is no relationship in patients who are taking fewer than three injections per day.
Surwit
Richard S
RS
Division of Medical Psychology, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, P.O. Box 3842, Durham, NC 27710, USA. richard.surwit@duke.edu
van Tilburg
Miranda A L
MA
Parekh
Priti I
PI
Lane
James D
JD
Feinglos
Mark N
MN
D000328:Adult; D000465:Algorithms; D001786:Blood Glucose / Q000378:metabolism*; D003863:Depression / Q000097:blood / Q000453:epidemiology*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000523:psychology*; D006279:Health Maintenance Organizations; D006801:Humans; D009657:North Carolina
D001786:Blood Glucose