Depression in patients with diabetes: does it impact clinical goals?
BACKGROUND
To examine whether depressive symptoms are associated with achievement of recommended goals for control of glucose, lipids, and blood pressure among patients with diabetes.


METHODS
We used a prospective cohort study of 1223 adults with diabetes that obtained self-reported depression symptoms from a survey. Medication use was obtained from claims data, and pharmacy and clinical data were obtained by manual review of paper medical records.


RESULTS
Diabetes patients with depression symptoms were less likely to be at their glucose goal (43% vs 50%; P = .0176) but more likely to be at their blood pressure goal (57% vs 51%; P = .0435). The association between lipids and depression symptoms was related to a lower rate for low-density lipoprotein testing (56% vs 68%; P < .0001). Treatment with antidepressants resulted in a greater percentage achieving glucose and blood pressure goals but not lipid goals.


CONCLUSIONS
Depression seems to have a variable impact on achieving these clinical goals, perhaps because the goals have differing measurement logistics and biological profiles. Further research is needed to learn whether better treatment of depressive symptoms leads to improvements in meeting diabetes clinical goals.
Rush
William A
WA
HealthPartners Research Foundation, Minneapolis, MN 55440, USA. Bill.A.Rush@healthpartners.com
Whitebird
Robin R
RR
Rush
Monica R
MR
Solberg
Leif I
LI
O'Connor
Patrick J
PJ
D000223:Adaptation, Psychological; D000928:Antidepressive Agents / Q000627:therapeutic use; D001786:Blood Glucose / Q000378:metabolism*; D015190:Blood Glucose Self-Monitoring / Q000592:standards*; D003863:Depression / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D048909:Diabetes Complications / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires
D000928:Antidepressive Agents; D001786:Blood Glucose; D008077:Lipoproteins, LDL