title: The effects of depression on diabetes knowledge, diabetes self-management, and perceived control in indigent patients with type 2 diabetes.
abstract: BACKGROUND
  This study was designed to assess differences in diabetes knowledge, diabetes self-management, and perceived control among depressed and nondepressed individuals in an indigent population with type 2 diabetes.
  
  
  METHODS
  Depressed and nondepressed patients with the clinical diagnosis of type 2 diabetes were recruited from an indigent care clinic. Subjects completed validated surveys to assess diabetes knowledge, diabetes self-management, and perceived control of diabetes. We compared demographic characteristics and diabetes knowledge, diabetes self-management, and perceived control of diabetes by depression status. Statistical analysis was performed with SPSS version 14.0 (SPSS, Inc., Chicago, IL).
  
  
  RESULTS
  Of the 201 subjects with diagnosed type 2 diabetes enrolled in the study, approximately 20% n = 40) of the sample was depressed. Subjects with depression were more likely to report self-care control problems (mean = 2.2 +/- 1.0 vs. 1.5 +/- 0.6, P < 0.001) and less likely to report positive attitude (mean = 2.9 +/- 0.7 vs. 3.7 +/- 0.5, P < 0.001), self-care ability (mean = 3.2 +/- 3.6 vs. 3.7 +/- 0.5, P < 0.001), and self-care adherence (mean = 3.3 +/- 0.9 vs. 4.1 +/- 0.6, P < 0.001). Depressed patients were less likely to report perceived control of diabetes (mean = 47.7 +/- 8.5 vs. 57.8 +/- 7.4, P < 0.001). There were no significant differences in diabetes knowledge, self-care understanding, and perceived importance of self-care between depressed and nondepressed patients.
  
  
  CONCLUSIONS
  In this indigent population with type 2 diabetes, diabetes knowledge did not differ significantly by depression status, but diabetes self-management practices and perceived control of diabetes differed significantly by depression status. Patients who were depressed had poorer diabetes self-care and felt they had less control over their disease.
authors.affiliation: Department of Medicine, Center for Health Disparities Research, Medical University of South Carolina, Charleston, SC 29425, USA. egedel@musc.edu
authors.forename: Leonard E
authors.initials: LE
authors.lastname: Egede
authors.forename: Charles
authors.initials: C
authors.lastname: Ellis
mesh_terms: D000328:Adult; D001294:Attitude to Health; D003863:Depression / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010465:Perception; D011203:Poverty; D012648:Self Care; D013022:South Carolina