Depression is a risk factor for poor glycemic control and retinopathy in African-Americans with type 1 diabetes.
OBJECTIVE
To examine longitudinal data about depression in relationship to glycemic control and as a risk factor for diabetic retinopathy (DR). Depression is a common psychiatric disorder among diabetic persons and has been shown in cross-sectional studies to be associated with the vascular complications of diabetes.


METHODS
A total of 483 African-American patients with Type 1 diabetes had a baseline examination and 6-year follow-up examination. Evaluations at both visits included administering the Beck Depression Inventory (BDI), a detailed ophthalmologic examination, retinal photographs, and measurement of glycosylated hemoglobin as an index of glycemic control. Six-year progression of DR between baseline and follow-up visits was evaluated from the change in retinopathy severity using the Early Treatment of Diabetic Retinopathy Study grading scale.


RESULTS
Patients with high BDI scores at both baseline and 6-year follow-up visits had significantly higher baseline glycosylated hemoglobin values (p = .01), and were more likely to show progression of DR (odds ratio (OR) = 2.44; 95% confidence interval (CI): 1.01-5.88; p = .049) and progression to proliferative diabetic retinopathy (PDR) (OR = 3.19; 95% CI: 1.30-7.87; p = .01) than patients with low BDI scores at both visits. This was independent of baseline medical risk factors for DR.


CONCLUSIONS
Six-year longitudinal data indicate that depression is significantly associated with both poor glycemic control and higher 6-year progression to PDR in African-Americans with Type 1 diabetes.
Roy
Monique S
MS
University of Medicine and Dentistry, New Jersey Medical School, Institute of Ophthalmology and Visual Science, Newark, NJ 07101-1709, USA. Roymo@umdnj.edu
Roy
Alec
A
Affouf
Mahmoud
M
D000328:Adult; D001741:Black or African American / Q000523:psychology; D015897:Comorbidity; D003866:Depressive Disorder / Q000208:ethnology*; D003922:Diabetes Mellitus, Type 1 / Q000208:ethnology*; D003930:Diabetic Retinopathy / Q000208:ethnology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009515:New Jersey / Q000453:epidemiology; D012307:Risk Factors; D012959:Socioeconomic Factors
D006442:Glycated Hemoglobin