Depressive symptoms and glycemic control in adolescents with type 1 diabetes: mediational role of blood glucose monitoring.
OBJECTIVE
To determine whether the association between depressive symptoms and glycemic control is mediated by blood glucose monitoring (BGM).


METHODS
A total of 276 adolescents with type 1 diabetes (mean age +/- SD, 15.6 +/- 1.4 years) completed a measure of depressive symptoms. Sociodemographic and family characteristics were obtained from caregivers. BGM frequency and glycemic control were obtained at a clinic visit.


RESULTS
Separate regression analyses revealed that depressive symptoms were associated with lower BGM frequency (B = -0.03; P = 0.04) and higher A1C (B = 0.03; P = 0.05) and that lower BGM frequency was associated with higher A1C (B = -0.39; P < 0.001). With depressive symptoms and BGM frequency included together, only BGM frequency was associated with A1C and depressive symptoms became nonsignificant (B = 0.02; P = 0.19). The Sobel test was significant (Z = 1.96; P < 0.05) and showed that 38% of the depression-A1C link can be explained by BGM.


CONCLUSIONS
BGM is a mediator between depressive symptoms and glycemic control in adolescents with type 1 diabetes.
McGrady
Meghan E
ME
Center for Treatment Adherence, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Laffel
Lori
L
Drotar
Dennis
D
Repaske
David
D
Hood
Korey K
KK
D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism*; D015190:Blood Glucose Self-Monitoring / Q000523:psychology*; D003863:Depression / Q000097:blood / Q000453:epidemiology*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000523:psychology*; D004522:Educational Status; D005006:Ethnicity; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D017533:Marital Status; D000297:Psychology, Adolescent; D020377:Self Efficacy
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin